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1.	Roos, Håkan, et al. (författare) Air bubble release and flow-induced forces in stent grafts 2017 Ingår i: Engineering Health. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Background: Stent grafts are used to treat aortic aneurysms, as a minimal invasive alternative to open surgery. The aorta is accessed via percutaneous punctures in the groins and insertion of guide wires. A stent graft is advanced over the guide wire and deployed in the desired position, using x-ray fluoroscopic guidance. The procedure significantly reduces short-term morbidity and mortality compared to open repair, but has a higher rate of late complications and re-interventions. Two possible complications are: release of air bubbles during thoracic stent graft deployment may lead to cerebral embolization and immediate stroke, and long-term migration due to flow-induced forces may lead to leakage into the aneurysm sack and remaining risk of aortic rupture. Objectives: Stent grafts are compressed in a long, soft and thin delivery catheter. Once the stent graft is in position, the surgeon withdraws the catheter, allowing the self-expanding stent graft to expand radially to the artery wall, or to a previously inserted stent graft. The stent graft is kept in place by the expansion force of the over-sized stent, and in some cases by anchoring hooks. Despite a strict preparation procedure, there is a risk that air is trapped in the compressed stent graft and released into the aorta during deployment. The present work describes two of our studies. In the first experimental study we measure the total amount of air released by two different brands of thoracic stent grafts and investigate the size and origin of the air bubbles. In the second experimental and numerical study angulated iliac limbs stent grafts are mounted in a pulsatile flow model to determine the flow-induced displacement forces under a variety of conditions.Methods: The air release measurements and visualizations are performed by inserting and deploying stent grafts in a closed water-filled container. A high-resolution and high-speed camera is used to capture the air release process, and the total amount of air collected in the container is measured. An experimental pulsatile flow model, with conditions similar to aortic in vivo conditions, is used to measure the proximal and distal displacement forces of iliac stent grafts under different angulations, pulsation frequencies, pressures, and configurations (tapered, tubular, bellbottom). Fluid-structure interaction simulations are used to determine the forces numerically.Results: We found that air is released during deployment of thoracic stent grafts and that the largest bubbles come from the proximal end. There is a significant difference between the two brands of stent grafts that have been investigated. The flow-induced forces are under some conditions comparable to the forces required to extract the iliac limb stent grafts. Both the forces and the graft movements increase with angulation and with perfusion pressure, but not with stroke rate. The distal displacement forces are particularly large for the bellbottom configuration. The origin of the forces is mainly the pressure, while the contributions of shear force and flow redirection are insignificant. The flexibility of the stent graft material reduces the forces (by 15% under the conditions in the numerical simulations in the present work).Conclusions: New packing and/or preparation procedures should be developed to reduce the amount of air released during deployment of thoracic stent grafts. Improved anchoring of the distal ends of stent grafts should be considered.References[1] Displacement Forces in Iliac Landing Zones and Stent Graft Interconnections in Endovascular Aortic Repair: An Experimental Study. Roos H, Ghaffari M, Falkenberg M, Chernoray V, Jeppsson A, Nilsson H.European Journal of Vascular and Endovascular Surgery 2014:47(3):262-267.
2.	Roos, Håkan, 1967, et al. (författare) Displacement Forces in Iliac Landing Zones and Stent Graft Interconnections in Endovascular Aortic Repair: An Experimental Study 2014 Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 47:3, s. 262-267 Tidskriftsartikel (refereegranskat)abstract Objectives: Stent graft migration influences the long-term durability of endovascular aortic repair. Flow-induced displacement forces acting on the attachment zones may contribute to migration. Proximal fixation of aortic stent grafts has been improved by using hooks, while distal fixation and stent graft interconnections depend on self-expansion forces only. We hypothesized that flow-induced displacement forces would be significant at the distal end, and would correlate with graft movements. Methods: As part of an experimental study, an iliac limb stent graft was inserted in a pulsatile flow model similar to aortic invivo conditions, and fixed-mounted at its proximal and distal ends to strain gauge load cells. Peak displacement forces at both ends and pulsatile graft movement were recorded at different graft angulations (0-90°), perfusion pressures (145/80, 170/90, or 195/100mmHg), and stroke frequencies (60-100b.p.m.). Results: Flow-induced forces were of the same magnitude at the proximal and distal end of the stent graft (peak 1.8N). Both the forces and graft movement increased with angulation and perfusion pressure, but not with stroke rate. Graft movement reached a maximum of 0.29±0.01mm per stroke despite fixed ends. There were strong correlations between proximal and distal displacement forces (r=0.97, p<.001), and between displacement forces and graft movement (r=0.98, p<.001). Conclusions: Pulsatile flow through a tubular untapered stent graft causes forces of similar magnitude at both ends and induces pulsatile graft movements in its unsupported mid-section. Peak forces are close to those previously reported to be required to extract a stent graft. The forces and movements increase with increasing graft angulation and perfusion pressure. Improved anchoring of the distal end of stent grafts may be considered. © 2013 European Society for Vascular Surgery.
3.	Roos, Håkan, 1967, et al. (författare) Displacement Forces in Stent Grafts: Influence of Diameter Variation and Curvature Asymmetry 2016 Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 52:2, s. 150-156 Tidskriftsartikel (refereegranskat)abstract Objectives: Long-term durability after endovascular aortic repair is influenced by stent graft migration causing types I and III endoleaks. Flow induced displacement forces have been shown to have the potential to cause migration. In this study, the influence of the distal diameter of iliac limb stent grafts and the shape of graft curvature on flow induced displacement forces, were investigated. Methods: In an experimental pulsatile flow model mimicking aortic conditions in vivo, flow induced displacement forces at the proximal and distal ends of iliac limb stent grafts were studied at different angles (0-90 degrees) and perfusion pressures (145/80, 170/90, 195/100 mmHg). Bell-bottomed, tapered, and non-tapered stent grafts and also asymmetric stent graft curvatures at 90 bend were studied. Measurements of graft movement were performed at all studied angulations and graft shapes. Results: For all stent graft diameters, flow induced displacement forces increased with higher pressure and increased stent graft angulation. Forces in the bell-bottom graft were considerably higher than in tapered and non-tapered grafts, with a markedly elevated peak force at the distal end (proximal end, 2.3 +/- 0.06 N and distal end, 6.9 +/- 0.05 N compared with 1.7 +/- 0.08 N and 1.6 +/- 0.08 N in non-tapered grafts; p <.001 both). Peak forces in tapered and non-tapered grafts were not significantly different between the proximal and distal end. In asymmetric stent graft curvatures, a significant increase in displacement forces was observed in the attachment zone that was closest to the stent graft bend. Graft movement increased with greater displacement forces. Conclusion: Flow induced displacement forces in iliac limb stent grafts are significant and are influenced by distal stent graft diameter and the shape of the graft curvature. The displacement forces are particularly high at the large distal end of bell-bottom grafts. Wide iliac arteries treated with bell-bottom stent grafts may require more vigilant surveillance and improved stent graft fixation.
4.	Roos, Håkan, et al. (författare) Fluid Pressure Derived Force is the Main Contributor to Iliac Limb Displacement Forces – Shear Force and Redirection of Flow are Negligible 2019 Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 58:6 (supplement 1), s. e18-e19 Tidskriftsartikel (refereegranskat)abstract Introduction - Complications after EVAR, including aortic rupture, continue to be a problem also in long term follow-up1. There is still a need for life-long surveillance and late re-interventions raises the question about long term EVAR-durability. Additional iliac stent grafts due to distal endoleak type I are among the more frequent among these late re-interventions2,3,4. There are indications that graft migration at iliac landing zones and graft interconnections are among the most common causes and that wide iliac arteries predispose for these complications5. Flow induced displacement forces have, in an experimental model, been shown to be significant also at distal landing zones in EVAR stent grafts6 and particularly high in grafts with large distal diameters7. These findings indicate that late EVAR failures are linked to flow induced displacement forces and subsequent graft migration. We have therefore conducted a study of fluid structure interaction with the aim to differentiate the magnitude of the different force components and numerically evaluate the forces acting on iliac limb stent grafts in different graft configurations. Methods - The displacement forces in iliac limb stent grafts were numerically evaluated using a finite volume approach for fluid-structure interaction (FSI) with the open source tool FOAM-extend-3.1. The grafts were modelled with homogeneous properties in three configurations; tapered (16 mm proximal diameter, 12 mm distal diameter), non tapered (16-16 mm) and bellbottom (16-27 mm), all at 90° angulation (see 16-27 in figure). Experimentally determined pulsatile conditions were applied for different pressures; 145/80, 170/90, 195/100 mmHg. Results - Stent graft displacement forces increased with higher fluid pressure in all graft configurations. Maximum forces in bellbottom grafts (proximal end 2.3 N, distal end 8.1 N) were particularly high compared to tapered (proximal end 2.5 N, distal end 1.2 N) and non tapered grafts (proximal end 2.5 N, distal end 2.5 N). The effects of shear stress and redirection of flow were together less than 2.8 % of the total forces in all graft configurations, whereas pressure derived forces were the main contributor to the forces acting on the stent graft. The flexibility of the stent graft absorbed up to 15 % of the forces. Conclusion - The forces acting on stent grafts during pulsatile flow are significant and particularly high in the distal end of grafts with large distal diameter. The main contributor to these displacement forces is pressure while the contribution of shear and redirection of flow are negligible. The flexibility of the stent graft tends to absorb a significant part of the forces.
5.	Tokarev, Mikhail, 1982, et al. (författare) DIC for Surface Motion Analysis Applied to Displacement of a Stent Graft for Abdominal Aortic Repair in a Pulsating Flow 2015 Ingår i: PIV15; 11th International Symposium on Particle Image Velocimetry, Santa Barbara, California, USA, September 14-16, 2015. ; , s. 1-12 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Stent graft migration has been recognized to influence the long-term durability of endovascular aortic repair. Flow-induced displacement forces acting on the attachment zones may contribute to this migration. An experimental perfusion model consisting of the flow loop described by Roos et al. 2014 was used for further characterization of the pulsating flow induced stent graft movements with monocular and stereoscopic configurations of an optical imaging system. This paper adds new information on displacement measurement accuracy and 3D deformation analysis of the stent graft, which is used for abdominal aortic aneurysm treatment. The work describes used modification of Soloff’s Stereo PIV reconstruction algorithm for surface motion analysis. It was found that the oscillation of the stent graft’s body in the perpendicular direction to the front plane was 5 times less than side movements of the bent stent graft. These results can be used for further studies on different stent graft geometrical configurations and CFD simulations using fluid-structure interaction approach.
6.	Yao, Huadong, 1982, et al. (författare) Simulation of Fluid-Structure Interaction in Biomechanics Using FOAM-Extend 2018 Ingår i: Proceedings of the 13th OpenFOAM Workshop. ; , s. 248-250 Konferensbidrag (refereegranskat)abstract Paper is extended abstract itself.
7.	Alm, Håkan, et al. (författare) ChatGPT a powerful assistant, when using Double-Loop Co-Design 2024 Konferensbidrag (refereegranskat)abstract Computers can now carry out tasks, by first learning from being given examples, rather than just doing exactly what they are told, this is often referred to as Machine Learning or AI. This has given almost endless possibilities what these machines can ultimately do. At the same time, it also gives us many threats and things to worry about from a safety, security and ethical point of view and voices are raised that we should control what AI is allowed to do by laws and regulations. By applying a Double loop Co-design approach to science this paper focusses on ChatGPT and researchers experience with effectiveness and ethics related to use o this tool. 3 workshops were conducted with totally 14 participants from 5 continents. Most of the respondents are positive and excited about what Chat GPT and AI can do for us, but they are also worried. The main concerns are that AI will do the creative and fun parts of our work and that it produces false facts. In conclusion, if applying a perspective conscious view of knowledge, AI can inspire human controlled creativity and informed decision making with multi-perspective views of reality.
8.	Andersson, Mattias, et al. (författare) A population-based study of post-endovascular aortic repair rupture during 15 years 2021 Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 74:3 Tidskriftsartikel (refereegranskat)abstract Objective: The devastating event of a ruptured abdominal aortic aneurysm (rAAA) in patients who have survived a previous AAA repair, either elective or urgent, is a feared and quite uncommon event. It has been suggested to partly explain the loss of the early survival benefit for endovascular aortic repair (EVAR) vs open surgical repair (OSR). The main objective of this study was to report the national incidence rate, risk factors and outcome of post-EVAR ruptures. Secondarily, the national incidence rate of ruptures after OSR (post-OSR ruptures) was investigated. Methods: We conducted a nationwide, population-based, retrospective cohort study using the inpatient and outpatient entries for all patients >40 years of age, receiving their first (index) surgical procedure for AAA, from 2001 to 2015. Only patients surviving their index procedure were included. The primary outcome was rAAA, registered after discharge from the index procedure (EVAR or OSR), identified in the Swedish National Patient Registry and the Cause of Death Registry. Results: In total, 14,859 patients survived their primary (index) AAA procedure. There were 6470 EVAR procedures, 5893 for intact AAA (iAAA) and 577 for rAAA. Of the 6470 EVAR patients, 86 cases of post-EVAR rupture were identified, corresponding with a cumulative incidence of 1.3% over a mean follow-up time of 3.9 years. The incidence rate was 3.4 (95% confidence interval [CI], 2.7-4.2)/1000 person-years. The independent risk factors identified for post-EVAR rupture were rAAA at index surgery HR 2.4 (95% CI, 1.4-4.1, p 0.002) and age (hazard ratio, 1.1; 95% CI, 1.0-1.1; P <.001). Freedom from post-EVAR rupture was 99%, 98%, and 96% at 3, 5, and 10 years, respectively. Total and postoperative mortality after post-EVAR rupture were 42% and 17% (30 days), 45% and 22% (90 days), and 53% and 33% (1 year). The incidence rate of post-OSR rupture was 0.9/1000 person-years (95% CI, 0.7-1.2). Conclusions: Post-EVAR rupture is a rare complication that can occur at any time after the index EVAR procedure. This finding may have implications for the discussion of limited follow-up programs and for the choice of procedure in patients with an AAA with a long life expectancy. An rAAA as the indication for the index surgery and age were identified as risk factors for post-EVAR rupture. The mortality associated with post-EVAR rupture is high, but lower than that of primary rAAA. The much lower risk of post-OSR rupture was confirmed, but must not be neglected as a possible late complication. © 2021 The Authors
9.	Andersson, Mattias, et al. (författare) Editor's Choice – Structured Computed Tomography Analysis can Identify the Majority of Patients at Risk of Post-Endovascular Aortic Repair Rupture 2022 Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 64, s. 166-174 Tidskriftsartikel (refereegranskat)abstract Objective: The main objective was to report mechanisms and precursors for post-endovascular aneurysm repair (EVAR) rupture. The second was to apply a structured protocol to explore whether these factors were identifiable on follow up computed tomography (CT) prior to rupture. The third objective was to study the incidence, treatment, and outcome of post-EVAR rupture. Methods: This was a multicentre, retrospective study of patients treated with standard EVAR at five Swedish hospitals from 2008 to 2018. Patients were identified from the Swedvasc registry. Medical records were reviewed up to 2020. Index EVAR and follow up data were recorded. The primary endpoint was post-EVAR rupture. CT at follow up and at post-EVAR rupture were studied, using a structured protocol, to determine rupture mechanisms and identifiable precursors. Results: In 1 805 patients treated by EVAR, 45 post-EVAR ruptures occurred in 43 patients. The cumulative incidence was 2.5% over a mean follow up of 5.2 years. The incidence rate was 4.5/1 000 person years. Median time to post-EVAR rupture was 4.1 years. A further six cases of post-EVAR rupture in five patients found outside the main cohort were included in the analysis of rupture mechanisms only. The rupture mechanism was type IA in 20 of 51 cases (39%), IB in 20 of 51 (39%) and IIIA/B in 11 of 51 (22%). One of these had type IA + IB combined. One patient had an aortoduodenal fistula without another mechanism being identified. Precursors had been noted on CT follow up prior to post-EVAR rupture in 16 of 51 (31%). Retrospectively, using the structured protocol, precursors could be identified in 43 of 51 (84%). In 17 of 27 (63%) cases missed on follow up but retrospectively identifiable, the mechanisms were type IB/III. Overall, the 30 day mortality rate after post-EVAR rupture was 47% (n = 24/51) and the post-operative mortality rate was 21% (n = 7/33). Conclusions: Most precursors of post-EVAR rupture are underdiagnosed but identifiable before rupture using a structured follow up CT protocol. Precursors of type IB and III failures caused the majority of post-EVAR ruptures.
10.	Arheden, Håkan, et al. (författare) Blood flow measurements 2006 Ingår i: MRI and CT of the Cardiovascular System. - 0781762715 ; , s. 71-90 Bokkapitel (övrigt vetenskapligt/konstnärligt)
11.	Bogdanovic, Marko, et al. (författare) Limb Graft Occlusion Following Endovascular Aneurysm Repair for Infrarenal Abdominal Aortic Aneurysm with the Zenith Alpha, Excluder, and Endurant Devices : a Multicentre Cohort Study 2021 Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier. - 1078-5884 .- 1532-2165. ; 62:4, s. 532-539 Tidskriftsartikel (refereegranskat)abstract Objective: Limb graft occlusion (LGO) is a serious complication after endovascular aneurysm repair (EVAR) and while device development enables treatment of increasingly complex aortic anatomy, little is known about how endograft type affects the risk of occlusion. This observational study aimed to explore the incidence of LGO after EVAR for three major endograft systems.Methods: All patients with standard EVAR as the primary intervention for infrarenal abdominal aortic aneurysm (AAA), between January 2012 and December 2018, at five Swedish vascular surgery centres, were included in this multicentre retrospective cohort study. LGO was defined as a total limb occlusion regardless of symptoms, or a treated significant stenosis. A nested case control (NCC) design with incidence density sampling of 1:3 was used for analysis of potential per-operative and morphological risk factors. Conditional logistic regression was used to estimate multivariable odds ratios (OR) with 95% confidence intervals (CI)Results: A total of 924 patients were included. The majority were male (84%), the mean age was 76 years (+/- 7.5 SD), and median AAA diameter was 59 mm (IQR 55, 67). Patients were treated with Zenith Alpha (n = 315, ZISL limbs), Excluder (n = 152, PLC/PXC limbs), and Endurant (n = 457, ETLW/ ETEW limbs). During median follow up of 37 months (IQR 21, 62), 55 occlusions occurred (5.9%); 39 with Zenith Alpha (12.4%), one with Excluder (0.7%), and 15 with Endurant (3.3%). In the NCC analysis, the Zenith Alpha device (OR 5.31, 95% CI 1.97 - 14.3), external iliac artery (EIA) landing (OR 5.91, 95% CI 1.30 - 26.7), and EIA diameter < 10 mm (OR 4.99, 95% CI 1.46 - 16.9) were associated with an increased risk of LGO.Conclusion: Endograft device type is an independent risk factor for LGO after EVAR. Specifically, the Zenith Alpha demonstrated an increased risk of LGO compared with the Endurant and Excluder devices. In addition, a narrow EIA and landing zone in EIA are also risk factors for LGO.
12.	Brandt, Jonathan, et al. (författare) Single postoperative infusion of zoledronic acid to improve patient-reported outcome after hip or knee replacement : study protocol for a randomised, controlled, double-blinded clinical trial 2020 Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:9 Tidskriftsartikel (refereegranskat)abstract INTRODUCTION: In Sweden, roughly 3000 patients are reoperated each year due to pain and loss of function related to a loosened hip or knee prosthesis. These reoperations are strenuous for the patient, technically demanding and costly for the healthcare system. Any such reoperation that can be prevented would be of great benefit. Bisphosphonates are drugs that inhibit osteoclast function. Several clinical trials suggest that bisphosphonates lead to improved implant fixation and one small study even indicates better functional outcome. Furthermore, in epidemiological studies, bisphosphonates have been shown to decrease the rate of revision for aseptic loosening by half. Thus, there are several indirect indications that bisphosphonates could improve patient-reported outcome, but no firm evidence. METHODS AND ANALYSIS: This is a pragmatic randomised, placebo-controlled, double-blinded, academic clinical trial of a single postoperative dose of zoledronic acid, in patients younger than 80 years undergoing primary total hip or knee replacement for osteoarthritis. Participants will be recruited from two orthopaedic departments. All surgeries will be performed, and study drugs given at Motala Hospital, Sweden. The primary endpoint is to investigate between-group differences in the Hip dysfunction and Osteoarthritis Outcome Score and the Knee injury and Osteoarthritis Outcome Score at 3-year follow-up. Secondary outcomes will be investigated at 1 year, 3 years and 6 years, and stratified for hip and knee implants. These secondary endpoints are supportive, exploratory or explanatory. A total of 1000 patients will be included in the study. ETHICS AND DISSEMINATION: The study has been approved by the Regional Ethical Review Board in Linköping (DNR 2015/286-31). The study will be reported in accordance with the Consolidated Standards of Reporting Trials statement for pharmacological trials. The results will be submitted for publication in peer-reviewed academic journals and disseminated to patient organisations and the media. TRIAL REGISTRATION NUMBER: EudraCT: No 2015-001200-55; Pre-results.
13.	Brohede, Ulrika, et al. (författare) Multifunctional implant coatings providing possibilities for fast antibiotics loading with subsequent slow release 2009 Ingår i: Journal of materials science. Materials in medicine. - : Springer Science and Business Media LLC. - 0957-4530 .- 1573-4838. ; 20:9, s. 1859-1867 Tidskriftsartikel (refereegranskat)abstract The possibility to fast-load biomimetic hydroxyapatite coatings on surgical implant with the antibiotics Amoxicillin, Gentamicin sulfate, Tobramycin and Cephalothin has been investigated in order to develop a multifunctional implant device offering sustained local anti-bacterial treatment and giving the surgeon the possibility to choose which antibiotics to incorporate in the implant at the site of surgery. Physical vapor deposition was used to coat titanium surfaces with an adhesion enhancing gradient layer of titanium oxide having an amorphous oxygen poor composition at the interface and a crystalline bioactive anatase TiO2 composition at the surface. Hydroxyapatite (HA) was biomimetically grown on the bioactive TiO2 to serve as a combined bone in-growth promoter and drug delivery vehicle. The coating was characterized using scanning and transmission electron microscopy, X-ray diffraction and X-ray photoelectron spectroscopy. The antibiotics were loaded into the HA coatings via soaking and the subsequent release and antibacterial effect were analyzed using UV spectroscopy and examination of inhibition zones in a Staphylococcus aureus containing agar. It was found that a short drug loading time of 15 min ensured antibacterial effects after 24 h for all antibiotics under study. It was further found that the release processes of Cephalothin and Amoxicillin consisted of an initial rapid drug release that varied unpredictably in amount followed by a reproducible and sustained release process with a release rate independent of the drug loading times under study. Thus, implants that have been fast-loaded with drugs could be stored for ~10 min in a simulated body fluid after loading to ensure reproducibility in the subsequent release process. Calculated release rates and measurements of drug amounts remaining in the samples after 22 h of release indicated that a therapeutically relevant dose could be achieved close to the implant surface for about 2 days. Concluding, the present study provides an outline for the development of a fast-loading slow-release surgical implant kit where the implant and the drug are separated when delivered to the surgeon, thus constituting a flexible solution for the surgeon by offering the choice of quick addition of antibiotics to the implant coating based on the patient need.
14.	Carlsson, Bengt, et al. (författare) Expression of functional growth hormone receptors in human granulosa cells 1992 Ingår i: Human Reproduction. - 0268-1161 .- 1460-2350. ; 7:7 Tidskriftsartikel (refereegranskat)
15.	Falkenberg, Mårten, 1959, et al. (författare) Ethylene vinyl alcohol copolymer (Onyx) to seal type 1 endoleak. A new technique. 2011 Ingår i: Vascular. - : SAGE Publications. - 1708-5381 .- 1708-539X. ; 19:2, s. 77-81 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to investigate whether the liquid embolic agent Onyx, an ethylene vinyl alcohol copolymer, can be used to seal type 1 endoleaks during endovascular aortic repair (EVAR). Six patients with large aortic aneurysms and remaining type 1 endoleaks during or after EVAR were treated with Onyx embolization through a microcatheter placed in the proximal neck in five cases and in the distal neck in one case. Four of the patients were treated using the chimney technique. The type 1 endoleak was primarily sealed by Onyx in all six patients. There was no distal embolization. Two patients had complications during follow-up. One patient had occlusions of chimney grafts to the renal arteries and to one leg extension. These occlusions were not anatomically related to Onyx embolization. One patient had late stentgraft migration of the Onyx-treated distal neck with aneurysm rupture 18 months after treatment. Early experience of Onyx embolization as a bailout solution of type 1 endoleaks after complicated EVAR is promising. However, effective seal with Onyx does not prevent late stentgraft migration. More reported patients and longer follow-up are necessary to evaluate this new technique.
16.	Hammo, Sari, et al. (författare) Outcome After Endovascular Repair of Ruptured Descending Thoracic Aortic Aneurysm : A National Multicentre Study 2019 Ingår i: European Journal of Vascular and Endovascular Surgery. - : Saunders Elsevier. - 1078-5884 .- 1532-2165. ; 57:6, s. 788-794 Tidskriftsartikel (refereegranskat)abstract Objective: The purpose of this multicentre study was to analyse the outcome of thoracic endovascular aortic repair (TEVAR) in patients with ruptured descending thoracic aortic aneurysm (rDTAA).Methods: This is a nationwide retrospective study including all patients who underwent TEVAR for rDTAA at six major vascular university centres in Sweden between January 2000 and December 2015. Outcome measures were analysed using Kaplan-Meier estimator and multivariable Cox regression.Results: There were 140 patients (age [mean +/- SD] 74.1 +/- 8.8 years; 56% men; aneurysm size 64.8 +/- 19 mm), with rDTAA. In 53 patients (37.9%), the left subclavian artery was covered, and in 25 patients (17.9%) arch vessel revascularisation was performed. In total, 61/136 patients (45%) had a major complication within 30 days post TEVAR. Stroke (n = 20; 14.7%) was the most common complication, followed by paraplegia (n = 13; 9.6%) and major bleeding (n = 13; 9.6%). TEVAR related complications during follow up included endoleaks 22.1% (30/136; 14 type 1a, six type 1b, 10 not defined). In total, re-interventions (n = 31) were required in 27/137 (19.7%) patients. The median follow up time was 17.0 months (range 0-132 months). The Kaplan-Meier estimated survival was 80.0% at one month, 71.7% at three months, 65.3% at one year, 45.9% at three years, and 31.9% at five years. Age (HR 1.03; 95% CI 1.00-1.07; p = .046), history of stroke (HR 2.35; 95% CI 1.194.63; p = .014), previous aortic surgery (HR 2.11; 95% CI 1.15-3.87; p = .016) as well as post-operative major bleeding (HR 4.40; 95% CI 2.20-8.81; p = .001), stroke (HR 2.63; 95% CI 1.37-5.03; p = .004), and renal failure (HR 8.25; 95% CI 2.69-25.35; p = .001) were all associated with mortality.Conclusions: This nationwide multicentre study of patients with rDTAA undergoing TEVAR showed acceptable short- but poor long-term survival. Adequate proximal and distal aortic sealing zones are important for technical success. High risk patients and post-operative complications need to be further addressed in an effort to improve outcome.
17.	Hansson, Edvin, et al. (författare) Correction: Particle Size-dependent Dissolution of Uranium Aerosols in Simulated Lung Fluid: A Case Study in a Nuclear Fuel Fabrication Plant (vol 123, pg 11, 2022) 2023 Ingår i: Health Physics. - : LIPPINCOTT WILLIAMS & WILKINS. - 0017-9078 .- 1538-5159. ; 124:1, s. 62-62 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
18.	Hansson, Edvin, 1987- (författare) Internal Dosimetry in Nuclear Fuel Fabrication : Occupational Exposure to Uranium Aerosols 2022 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract The production of nuclear fuel can be associated with occupational exposure to ionizing radiation from radioactive decay of uranium. Such exposure must be sufficiently low and radiation doses adequately determined. Radiation doses from internal exposure, i.e., following intake (usually inhalation), cannot be estimated using dosimeters, but must be calculated based on indirect measurements in combination with biokinetic models.Such biokinetic models have been developed and refined for decades. Good knowledge of the material characteristics is crucial. However, the physicochemical properties of chemical compounds can vary between different production facilities. Aerosol size distributions and dissolution characteristics in lung fluid are of particular importance. The latter is important since dissolved material is absorbed to blood, whereupon a large fraction reaches the urine after filtering by the kidneys. This enables urine sampling as a method to monitor occupational exposure.The aim of this thesis was to investigate the physicochemical properties of uranium aerosols and their implication on internal dose assessments at a nuclear fuel fabrication plant in Sweden. Uranium aerosols were sampled and size fractionated using personal cascade impactors carried by workers at the factory’s different main workshops. Aerosols were studied using scanning electron microscopy in Paper I. In Paper II the activity size distributions were determined and in Paper III dissolution rates in simulated lung fluid were investigated. Paper IV is an internal dose assessment based on records of urine sample analyses from about 10 years of routine occupational exposure monitoring of uranium pelletizing workers at the site.For a median worker, the urinary daily excretion rate of uranium increased due to chronic exposure for about 1000 days, after which the excretion rate stabilized. This suggests that inhaled material dissolves in the respiratory tract rapidly enough to prevent a net buildup in the lung after several years of exposure. This could be modelled using the default recommendations for uranium oxide materials provided by the International Commission on Radiological Protection. However, the best model fit to measurement data was obtained using a different set of parameters, that showed some discrepancies with results from Papers II-III. For individual cases, excretion rates could vary between sampling occasions to a greater extent than predicted using the default recommendations, which could indicate a more rapid body clearance than expected. Whether this is an effect of experimental methods or simplifications in the biokinetic models should be further investigated in future work.
19.	Hansson, Edvin, 1987-, et al. (författare) Particle Size-dependent Dissolution of Uranium Aerosols in Simulated Lung Fluid : A Case Study in a Nuclear Fuel Fabrication Plant 2022 Ingår i: Health Physics. - : Lippincott, Williams & Wilkins. - 0017-9078 .- 1538-5159. ; 123:1, s. 11-27 Tidskriftsartikel (refereegranskat)abstract Inhalation exposure to uranium aerosols can be a concern in nuclear fuel fabrication. The ICRP provides default absorption parameters for various uranium compounds but also recommends determination of material-specific absorption parameters to improve dose calculations for individuals exposed to airborne radioactivity. Aerosol particle size influences internal dosimetry calculations in two potentially significant ways: the efficiency of particle deposition in the various regions of the respiratory tract is dependent on aerodynamic particle size, and the dissolution rate of deposited materials can vary according to particle size, shape, and porosity because smaller particles tend to have higher surface-to-volume ratios than larger particles. However, the ICRP model assumes that deposited particles of a given material dissolve at the same rate regardless of size and that uptake to blood of dissolved material normally occurs instantaneously in all parts of the lung (except the anterior portion of the nasal region, where zero absorption is assumed). In the present work, the effect of particle size on dissolution in simulated lung fluid was studied for uranium aerosols collected at the plant, and its influence on internal dosimetry calculations was evaluated. Size fractionated uranium aerosols were sampled at a nuclear fuel fabrication plant using portable cascade impactors. Absorption parameters, describing dissolution of material according to the ICRP Human Respiratory Tract Model, were determined in vitro for different size fractions using simulated lung fluid. Samples were collected at 16 time-points over a 100-d period. Uranium content of samples was determined using inductively coupled plasma mass spectrometry and alpha spectrometry. In addition, supplementary experiments to study the effect of pH drift and uranium adsorption on filter holders were conducted as they could potentially influence the derived absorption parameters. The undissolved fraction over time was observed to vary with impaction stage cut-point at the four main workshops at the plant. A larger fraction of the particle activity tended to dissolve for small cut-points, but exceptions were noted. Absorption parameters (rapid fraction, rapid rate, and slow rate), derived from the undissolved fraction over time, were generally in fair agreement with the ICRP default recommendations for uranium compounds. Differences in absorption parameters were noted across the four main workshops at the plant (i.e., where the aerosol characteristics are expected to vary). The pelletizing workshop was associated with the most insoluble material and the conversion workshop with the most soluble material. The correlation between derived lung absorption parameters and aerodynamic particle size (impactor stage cut-point) was weak. For example, the mean absorption parameters derived from impaction stages with low (taken to be <5 mu m) and large (>= 5 mu m) cut-points did not differ significantly. Drift of pH and adsorption on filter holders appeared to be of secondary importance, but it was found that particle leakage can occur. Undissolved fractions and to some degree derived lung absorption parameters were observed to vary depending on the aerodynamic size fraction studied, suggesting that size fractionation (e.g., using cascade impactors) is appropriate prior to conducting in vitro dissolution rate experiments. The 0.01-0.02 mu m and 1-2 mu m size ranges are of particular interest as they correspond to alveolar deposition maxima in the Human Respiratory Tract Model (HRTM). In the present work, however, the dependency on aerodynamic size appeared to be of minor importance, but it cannot be ruled out that particle bounce obscured the results for late impaction stages. In addition, it was noted that the time over which simulated lung fluid samples are collected (100 d in our case) influences the curve-fitting procedure used to determine the lung absorption parameters, in particular the slow rate that increased if fewer samples were considered.
20.	Hatwaambo, Sylvester, et al. (författare) Mitigating the non-uniform illumination in low concentrating CPCs using structured reflectors 2009 Ingår i: Solar Energy Materials and Solar Cells. - : Elsevier BV. - 0927-0248 .- 1879-3398. ; 93:11, s. 2020-2024 Tidskriftsartikel (refereegranskat)abstract One problem in concentrating photovoltaic systems without active cooling is the formation of hot spots on the solar module cells. These hotspots are a result of uneven concentration of radiation within the solar module cells. The overall effect of concentrated heating is the reduction in the fill-factor of the solar module cell and the subsequent decrease in the overall efficiency of the system. In this paper, we investigate one alternative of improving the performance of a low concentrating photovoltaic system using semi-diffuse rolled reflective elements. Our results indicate that rolling marks on the reflector aligned parallel to the plane of the solar module cell improve the performance of the photovoltaic system. (C) 2009 Elsevier B.V. All rights reserved.
21.	Helby, Peter, et al. (författare) Market development problems for sustainable bio-energy systems in Sweden. (The BIOMARK project) 2004 Rapport (övrigt vetenskapligt/konstnärligt)
22.	Hobro, Sture, et al. (författare) Dialysis as a Novel Adjuvant Treatment for Malignant Cancers 2022 Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 14:20 Forskningsöversikt (refereegranskat)abstract Cancer metabolism is characterized by an increased utilization of fermentable fuels, such as glucose and glutamine, which support cancer cell survival by increasing resistance to both oxidative stress and the inherent immune system in humans. Dialysis has the power to shift the patient from a state dependent on glucose and glutamine to a ketogenic condition (KC) combined with low glutamine levels—thereby forcing ATP production through the Krebs cycle. By the force of dialysis, the cancer cells will be deprived of their preferred fermentable fuels, disrupting major metabolic pathways important for the ability of the cancer cells to survive. Dialysis has the potential to reduce glucose levels below physiological levels, concurrently increase blood ketone body levels and reduce glutamine levels, which may further reinforce the impact of the KC. Importantly, ketones also induce epigenetic changes imposed by histone deacetylates (HDAC) activity (Class I and Class IIa) known to play an important role in cancer metabolism. Thus, dialysis could be an impactful and safe adjuvant treatment, sensitizing cancer cells to traditional cancer treatments (TCTs), potentially making these significantly more efficient.
23.	Hubers, Anna A M, et al. (författare) Suicidal ideation in a European Huntington's disease population 2013 Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 151:1, s. 58-248 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Previous studies indicate increased prevalences of suicidal ideation, suicide attempts, and completed suicide in Huntington's disease (HD) compared with the general population. This study investigates correlates and predictors of suicidal ideation in HD.METHODS: The study cohort consisted of 2106 HD mutation carriers, all participating in the REGISTRY study of the European Huntington's Disease Network. Of the 1937 participants without suicidal ideation at baseline, 945 had one or more follow-up measurements. Participants were assessed for suicidal ideation by the behavioural subscale of the Unified Huntington's Disease Rating Scale (UHDRS). Correlates of suicidal ideation were analyzed using logistic regression analysis and predictors were analyzed using Cox regression analysis.RESULTS: At baseline, 169 (8.0%) mutation carriers endorsed suicidal ideation. Disease duration (odds ratio [OR]=0.96; 95% confidence interval [CI]: 0.9-1.0), anxiety (OR=2.14; 95%CI: 1.4-3.3), aggression (OR=2.41; 95%CI: 1.5-3.8), a previous suicide attempt (OR=3.95; 95%CI: 2.4-6.6), and a depressed mood (OR=13.71; 95%CI: 6.7-28.0) were independently correlated to suicidal ideation at baseline. The 4-year cumulative incidence of suicidal ideation was 9.9%. Longitudinally, the presence of a depressed mood (hazard ratio [HR]=2.05; 95%CI: 1.1-4.0) and use of benzodiazepines (HR=2.44; 95%CI: 1.2-5.0) at baseline were independent predictors of incident suicidal ideation, whereas a previous suicide attempt was not predictive.LIMITATIONS: As suicidal ideation was assessed by only one item, and participants were a selection of all HD mutation carriers, the prevalence of suicidal ideation was likely underestimated.CONCLUSIONS: Suicidal ideation in HD frequently occurs. Assessment of suicidal ideation is a priority in mutation carriers with a depressed mood and in those using benzodiazepines.
24.	Johansson, Lars, et al. (författare) Lipid Mobilization Following Roux-en-Y Gastric Bypass Examined by Magnetic Resonance Imaging and Spectroscopy 2008 Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 18:10, s. 1297-1304 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Recent developments of magnetic resonance imaging (MRI) and spectroscopy have made it possible to quantify lipid deposited in different tissues. To what extent an improvement of glucose tolerance shortly after Roux-en-Y gastric bypass surgery (RYGBP) is reflected in lipid levels in liver and skeletal muscle, markers of insulin resistance, has not been clarified. METHODS: Whole-body MRI and MR spectroscopy (MRS) of liver and muscle and measurements of biochemical markers of glucose and lipid metabolism were performed at baseline and 1, 6, and 12 months following surgery in seven morbidly obese women. Volumes of adipose tissue depots and liver and muscle lipids were assessed from the MRI/MRS data. RESULTS: At 1 month postoperatively, body mass index and visceral and subcutaneous adipose tissues were reduced by 9%, 26%, and 10%, respectively, whereas no reductions in intrahepatocellular or skeletal intramyocellular lipid concentrations were found. Free fatty acid and beta-hydroxybutyrate levels were elevated two- and sixfold, respectively; glucose and insulin levels were lowered, indicating increased insulin sensitivity. Further weight loss up to 1 year was associated with reductions in all investigated lipid depots investigated, with the exception of the intramyocellular compartment. CONCLUSION: RYGBP causes rapid lipid mobilization from visceral and subcutaneous adipose depots and enhanced free fatty acid flux to the liver. An exceptional disconnection between liver fat and insulin sensitivity occurs in the early dynamic phase after surgery. However, in the late phase, the energy restriction imposed by the surgical procedure also reduces the liver lipids, but not the intramyocellular lipids.
25.	Kuchenbaecker, Karoline B., et al. (författare) Risks of breast, ovarian, and contralateral breast cancer for BRCA1 and BRCA2 mutation carriers 2017 Ingår i: JAMA - Journal of the American Medical Association. - : American Medical Association (AMA). - 0098-7484. ; 317:23, s. 2402-2416 Tidskriftsartikel (refereegranskat)abstract IMPORTANCE The clinical management of BRCA1 and BRCA2 mutation carriers requires accurate, prospective cancer risk estimates. OBJECTIVES To estimate age-specific risks of breast, ovarian, and contralateral breast cancer for mutation carriers and to evaluate risk modification by family cancer history and mutation location. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study of 6036 BRCA1 and 3820 BRCA2 female carriers (5046 unaffected and 4810 with breast or ovarian cancer or both at baseline) recruited in 1997-2011 through the International BRCA1/2 Carrier Cohort Study, the Breast Cancer Family Registry and the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer, with ascertainment through family clinics (94%) and population-based studies (6%). The majority were from large national studies in the United Kingdom (EMBRACE), the Netherlands (HEBON), and France (GENEPSO). Follow-up ended December 2013; median follow-up was 5 years. EXPOSURES BRCA1/2 mutations, family cancer history, and mutation location. MAIN OUTCOMES AND MEASURES Annual incidences, standardized incidence ratios, and cumulative risks of breast, ovarian, and contralateral breast cancer. RESULTS Among 3886 women (median age, 38 years; interquartile range [IQR], 30-46 years) eligible for the breast cancer analysis, 5066 women (median age, 38 years; IQR, 31-47 years) eligible for the ovarian cancer analysis, and 2213 women (median age, 47 years; IQR, 40-55 years) eligible for the contralateral breast cancer analysis, 426 were diagnosed with breast cancer, 109 with ovarian cancer, and 245 with contralateral breast cancer during follow-up. The cumulative breast cancer risk to age 80 years was 72%(95%CI, 65%-79%) for BRCA1 and 69%(95%CI, 61%-77%) for BRCA2 carriers. Breast cancer incidences increased rapidly in early adulthood until ages 30 to 40 years for BRCA1 and until ages 40 to 50 years for BRCA2 carriers, then remained at a similar, constant incidence (20-30 per 1000 person-years) until age 80 years. The cumulative ovarian cancer risk to age 80 years was 44%(95%CI, 36%-53%) for BRCA1 and 17%(95%CI, 11%-25%) for BRCA2 carriers. For contralateral breast cancer, the cumulative risk 20 years after breast cancer diagnosis was 40% (95%CI, 35%-45%) for BRCA1 and 26%(95%CI, 20%-33%) for BRCA2 carriers (hazard ratio [HR] for comparing BRCA2 vs BRCA1, 0.62; 95%CI, 0.47-0.82; P=.001 for difference). Breast cancer risk increased with increasing number of first- and second-degree relatives diagnosed as having breast cancer for both BRCA1 (HR for 2 vs 0 affected relatives, 1.99; 95%CI, 1.41-2.82; P<.001 for trend) and BRCA2 carriers (HR, 1.91; 95%CI, 1.08-3.37; P=.02 for trend). Breast cancer risk was higher if mutations were located outside vs within the regions bounded by positions c.2282-c.4071 in BRCA1 (HR, 1.46; 95%CI, 1.11-1.93; P=.007) and c.2831-c.6401 in BRCA2 (HR, 1.93; 95%CI, 1.36-2.74; P<.001). CONCLUSIONS AND RELEVANCE These findings provide estimates of cancer risk based on BRCA1 and BRCA2 mutation carrier status using prospective data collection and demonstrate the potential importance of family history and mutation location in risk assessment.
26.	Larzon, Thomas, et al. (författare) A randomized controlled trial of the fascia suture technique compared with a suture-mediated closure device for femoral arterial closure after endovascular aortic repair Annan publikation (övrigt vetenskapligt/konstnärligt)
27.	Lind, Monica, et al. (författare) Persistent organic pollutants and adipose tissue distribution 2012 Ingår i: Toxicology Letters. - : Elsevier. - 0378-4274 .- 1879-3169. ; 211:Supplement, s. S82- Tidskriftsartikel (refereegranskat)
28.	Lind, P. Monica, et al. (författare) Serum concentrations of phthalate metabolites are related to abdominal fat distribution two years later in elderly women 2012 Ingår i: Environmental Health. - 1476-069X. ; 11:1, s. 21- Tidskriftsartikel (refereegranskat)abstract BACKGROUND:Phthalates, commonly used to soften plastic goods, are known PPAR-agonists affecting lipid metabolism and adipocytes in the experimental setting. We evaluated if circulating concentrations of phthalates were related to different indices of obesity using data from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Data from both dual-energy X-ray absorptiometry (DXA) and abdominal magnetic resonance imaging (MRI) were used.METHODS: 1,016 subjects aged 70 years were investigated in the PIVUS study. Four phthalate metabolites were detected in the serum of almost all subjects (> 96%) by an API 4000 liquid chromatograph/tandem mass spectrometer. Abdominal MRI was performed in a representative subsample of 287 subjects (28%), and a dual-energy X-ray absorptiometry (DXA)-scan was obtained in 890 (88%) of the subjects two year following the phthalate measurements.RESULTS:In women, circulating concentrations of mono-isobutyl phthalate (MiBP) were positively related to waist circumference, total fat mass and trunk fat mass by DXA, as well as to subcutaneous adipose tissue by MRI following adjustment for serum cholesterol and triglycerides, education, smoking and exercise habits (all p < 0.008). Mono-methyl phthalate (MMP) concentrations were related to trunk fat mass and the trunk/leg-ratio by DXA, but less powerful than MiBP. However, no such statistically significant relationships were seen in men.CONCLUSIONS:The present evaluation shows that especially the phthalate metabolite MiBP was related to increased fat amount in the subcutaneous abdominal region in women measured by DXA and MRI two years later.
29.	Nordanstig, Joakim, et al. (författare) Deep Femoral Vein Reconstruction of the Abdominal Aorta and Adaptation of the Neo-Aortoiliac System Bypass Technique in an Endovascular Era. 2019 Ingår i: Vascular and endovascular surgery. - : SAGE Publications. - 1938-9116 .- 1538-5744. ; 53:1, s. 28-34 Tidskriftsartikel (refereegranskat)abstract Primary infection of the abdominal aorta is a rare pathology that may threaten the integrity of the aortic wall, while secondary aortic prosthesis infection represents a devastating complication to open surgical and endovascular aortic surgery. Curative treatment is achievable by removal of all infected prosthetic material followed by a vascular reconstruction.Twelve consecutive patients treated with the neo-aortoiliac system bypass (NAIS) procedure were reviewed. Nine were treated for a secondary aortic prosthesis infection (tube graft n = 3, bifurcated graft n = 4, endovascular aortic repair (EVAR) stent graft n = 1, and fenestrated EVAR [FEVAR] stent graft n = 1), while 3 patients underwent NAIS repair due to an emergent primary mycotic aortoiliac aneurysm. Primary Results: Ten of 12 patients survived 30 days. Three patients were operated on acutely, and 9 patients had elective or subacute NAIS surgery. Two of 3 patients operated acutely died within 30 days, whereas no 30-day or 1-year mortality was observed in patients undergoing elective or subacute surgery. The median time from primary reconstruction to the NAIS procedure was 11 months (range: 0-201 months). Stent grafts (n = 5 of 12) were in 4 cases explanted using endovascular balloon clamping. Of the explanted endografts, 2 patients presented with a secondary graft infection after EVAR/FEVAR, while 3 patients had been emergently treated with endovascular cuffs as a "bridge-to-surgery" procedure due to aortoenteric fistula (AEF). Patients who received a "bridge-to-surgery" regimen were treated with the NAIS procedure within 8 weeks (median 27 days, range: 27-60) after receiving emergency stent grafting.Aortic balloon-clamping during explantation of infected aortic prosthetic endografts is feasible and facilitates complete endograft removal. Endovascular bridging procedures could be beneficiary in the treatment of AEF or anastomotic dehiscence due to graft infection, offering a possibility to convert the acute setting to an elective definitive reconstructive procedure with a higher overall success rate.
30.	Olsson, Per-Ola, et al. (författare) Unbroken Digital Data Flow In The Built Environment Process : A Case Study In Sweden 2019 Ingår i: Int. Arch. Photogramm. Remote Sens. Spatial Inf. Sci., XLII-2/W13. ; XLII-2/W13, s. 1347-1352 Konferensbidrag (refereegranskat)abstract An unbroken digital data flow would save substantial resources in the built environment process. In this study, which is part of a larger Swedish project, data delivery specifications and methods to integrate BIM and geodata are developed and tested with the aim to facilitate such an unbroken data flow. The main focus areas of the study are: (1) specifications that enables building permission applications based on BIM data to automate the building permission process, (2) reuse of as-built BIM models to update geodata when a building is constructed and (3) a national Swedish CityGML ADE for buildings. The study shows that building permission applications can be partly automated even though the delivery specifications were in the early stages of development at the time of a performed test case. With fully implemented delivery specifications more regulations can be checked. Furthermore, the study demonstrates how a BIM model can be georeferenced with a standard deviation of the transformation of 3 cm compared to field measurements performed with a total station. The georeferenced BIM model can then be converted to a LOD2 geodata building model to update existing geodata. Finally, a proposal for a national Swedish CityGML ADE for buildings is presented.
31.	Roos, Håkan, 1967, et al. (författare) Predisposing Factors for Re-interventions with Additional Iliac Stent Grafts After Endovascular Aortic Repair. 2017 Ingår i: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. - : Elsevier BV. - 1532-2165. ; 53:1, s. 89-94 Tidskriftsartikel (refereegranskat)abstract Endoleaks of type Ib and III are relatively common causes of re-intervention after EVAR. The aim was to determine underlying causes and identify anatomical factors associated with these re-interventions.A total of 444 patients with standard bifurcated stent grafts were included in a retrospective observational study. Patients requiring additional iliac stent grafts (n=24) were compared to those who did not (n=420). Pre- and post-operative CT examinations were reviewed in patients with additional iliac stents. Reasons for re-interventions were defined as migration (>5mmat the distal end or at interconnections), progression of disease (iliac artery diameter exceeding graft diameter), inadequate distal seal length at primary repair, or a combination of these factors.Twenty-four patients received 31 additional grafts in 30 limbs after a median 46 months (range 2-92 months). Five re-interventions (21%) were due to rupture. Re-intervened limbs had a larger iliac artery diameter 18mm (25th and 75th percentile 20-25) versus 15mm (13-18mm), p<.001. The degree of iliac limb oversizing at primary EVAR was lower in re-intervened patients (11% (8-18%) versus 18% (12-26%), p=.003). In re-intervened patients, iliac attachment zones were shorter in treated limbs than in untreated 23mm (11-34) versus 34mm (25-44), p<.001). Sixteen of 31 re-interventions (51%) were caused by migration (10at the distal landing site, 6at interconnections), nine of 31 (29%) by disease progression, and nine of 31 (29%) had inadequate initial stent graft placement. Three of 31 re-interventions (10%) were done as proactive procedures.Additional iliac stent grafting occurred late after primary repair; a considerable number were caused by rupture. A low degree of oversizing, migration at the distal landing site, separation of stent graft interconnections, disease progression at the distal landing site, and inadequate initial stent graft placement may all contribute. Patients with large iliac dimensions and short attachment zones may need a larger degree of oversizing and more vigorous surveillance.
32.	Roos, Håkan, 1967 (författare) Re-interventions after endovascular aortic repair: clinical and experimental studies 2016 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Background: Endovascular aortic repair (EVAR) has lower morbidity and mortality than open surgery. Late complications and re-interventions are more common, however, and the timing of different re-interventions and their respective underlying causes are not fully understood. Aims: The overall aim was to describe re-interventions after EVAR and to identify possible underlying causes. Specific aims were as follows: 1. To describe re-interventions after EVAR, including incidence, indications, procedures, and outcome, concentrating especially on non-access-related re-interventions. 2. To determine underlying causes and to identify anatomical factors associated with additional iliac stent grafting. 3. To study flow-induced displacement forces in iliac limb stent grafts and the influence of stent graft angulation, fluid pressure, pulsation frequency, distal diameter of the stent graft, and asymmetric graft curvatures in an experimental aortic model. 4. To describe a new endovascular technique to close small entries that persist in the aortic arch. Materials and methods: Studies 1 and 2 were retrospective single-centre cohort studies of re-interventions after standard EVAR, focusing especially on non-access-related re-interventions. In Study 1, incidence, indications, procedures, and outcome were analyzed in 405 patients. In Study 2, 24 patients with additional iliac stent grafts after EVAR were studied. Computed tomography examinations were reviewed in detail regarding causes of re-intervention and underlying anatomic factors. These patients were compared with 420 patients treated with bifurcated EVAR during the same time period who did not require additional iliac stent grafts during follow-up, regarding patient characteristics and preoperative anatomic measurements. Studies 3 and 4 involved investigation of flow-induced displacement forces in iliac limb stent grafts in an experimental flow model mimicking physiologic conditions. In Study 3, the forces on a tubular stent graft with symmetric curvature were studied in relation to graft angulation, fluid pressure, and stroke rate. In Study 4 tapered, non-tapered, and bell-bottom grafts were studied at symmetric graft curvature and non-tapered grafts were studied at asymmetric curvature. Study 5 involved a new endovascular technique for closure of persistent small entries in selected patients with aneurysmal dilatation of chronic aortic dissections. Results: Study 1 showed that embolization of endoleak type II and placement of additional iliac stent grafts were the most common re-interventions after EVAR. These interventions were performed long after the initial intervention. Medium-term outcome in patients with re-intervention was comparable to that in patients without re-intervention. Study 2 showed that a considerable number of additional iliac stent grafting were caused by rupture. Migration at the distal landing site or graft interconnections was the most common cause, followed by disease progression. Study 3 demonstrated that flow-induced displacement forces were of similar magnitude at both ends of a non-tapered iliac stent graft, and the force increased with increasing graft angulation and fluid pressure but not with increasing pulse frequency. There was a high correlation between pulsatile graft movement and displacement forces. Study 4 showed that there were particularly high displacement forces in bell-bottom grafts, and that the forces were dependent on distal graft diameter and shape of the curvature. Study 5 showed that endovascular closure of persistent entries in chronic dissections is feasible, and in selected patients it may be an alternative to open surgery. Conclusions: Re-interventions are still common after EVAR, but most are percutaneous procedures and outcomes are generally good. Additional iliac stent grafting is one of the more frequent re-interventions, and in most cases it is related to stent graft migration, with a higher risk in patients with large iliac diameters and short attachment zones. Flow-induced displacement forces may have a role in the increased risk of migration. Patients with EVAR landing zones in wide iliac arteries may need improved graft fixation and more vigorous surveillance.
33.	Roos, John Magnus, et al. (författare) Covid-19 and Online Shopping of Groceries Across Generation Cohorts in Sweden 2024 Ingår i: Proceedings of World Conference on Information Systems for Business Management. - Singapore : Springer. - 9789819983452 - 9789819983469 ; , s. 151-161 Konferensbidrag (refereegranskat)abstract The present study aims to explore online shopping of groceries across generation cohorts in Sweden during Covid-19, particularly regarding the oldest generation cohort—the Dutifuls (born 1945 or earlier). The data were collected through three large surveys, representative for the Swedish population in the age range 18–85. The field period for the first survey was September 17, 2018–January 21, 2019 (N = 1754). The field period for the second survey was April 14–June 28, 2020 (N = 2501). The field period for the third survey was September 20–December 30, 2021 (N = 1588). Online grocery shopping in Sweden has increased remarkably since the outbreak of Covid-19, especially among the Dutifuls. However, the same generation cohort decreased their online shopping of groceries in the end of 2021. The findings are discussed in relation to limitations and practical implications. The decline of online shopping of groceries among the Dutifuls needs to be followed-up and explained by further research.
34.	Roos, John Magnus, et al. (författare) Covid-19 and online shopping of groceries across generation cohorts: Representative samples of the Swedish population 2024 Konferensbidrag (refereegranskat)abstract The present study aims to explore online shopping of groceries across generation cohorts in Sweden during Covid-19, particularly regarding the oldest generation cohort – the Dutifuls (born 1945 or earlier). The data were collected through three large surveys, representative for the Swedish population in the age range 18 – 85. The field period for the first survey was September 17, 2018–January 21, 2019 (N = 1,754). The field period for the second survey was April 14 – June 28, 2020 (N = 2,501). The field period for the third survey was September 20 – December 30, 2021 (N = 1,588). Online grocery shopping in Sweden has increased remarkably since the outbreak of Covid-19, especially among the Dutifuls. However, the same generation cohort decreased their online shopping of groceries in the end of 2021. The findings are discussed in relation to limitations and practical implications. The decline of online shopping of groceries among the Dutifuls needs to be followed-up and explained by further research.
35.	Roos, Vendela, et al. (författare) Circulating Levels of Persistent Organic Pollutants in Relation to Visceral and Subcutaneous Adipose Tissue by Abdominal MRI 2013 Ingår i: Obesity. - : Wiley-Blackwell. - 1930-7381 .- 1930-739X. ; 21:2, s. 413-418 Tidskriftsartikel (refereegranskat)abstract Objective: We and others have shown relationships between circulating levels of persistent organic pollutants (POPs) and different measures of obesity in both cross-sectional and prospective studies. Since viscerally located fat seems to be the most harmful type, we investigated whether plasma POP levels were more closely related to visceral adipose tissue (VAT) than to subcutaneous adipose tissue (SAT).Design and Methods: Thousand hundred and sixteen subjects aged 70 years were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study; 23 POPs were analyzed using high-resolution gas chromatography/ high-resolution mass spectrometry. Abdominal magnetic resonance imaging, measuring VAT and SAT, respectively, was performed in a representative subsample of 287 subjects.Results: The less chlorinated polychlorinated biphenyl (PCB) congeners (105 and 118), and the pesticides dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB), and trans-nonachlordane (TNC) were positively related to both VAT and SAT, whereas the more highly chlorinated PCBs (153, 156, 157, 169, 170, 180, 194, 206, and 209) were inversely related to both VAT and SAT. PCB189 was related to the VAT/SAT ratio in an inverted U-shaped manner (P = 0.0008).Conclusions: In conclusion, the results were in accordance with our previous studies using waist circumference and fat mass as obesity measure. However, the novel finding that PCB189 was related to the VAT/SAT ratio deserves further investigation since exposure to this PCB congener, which has previously been linked to diabetes development, might thereby play a role in the distribution of abdominal adipose tissue.
36.	Roos, Vendela, et al. (författare) Circulating Levels of Persistent Organic Pollutants in Relation to Visceral and Subcutaneous Adipose Tissue by Abdominal MRI 2013 Ingår i: Obesity. - : Wiley. - 1930-7381 .- 1930-739X. ; 21:2, s. 413-418 Tidskriftsartikel (refereegranskat)abstract We and others have shown relationships between circulating levels of persistent organic pollutants (POPs) and different measures of obesity in both cross-sectional and prospective studies. Since viscerally located fat seems to be the most harmful type, we investigated whether plasma POP levels were more closely related to visceral adipose tissue (VAT) than to subcutaneous adipose tissue (SAT). Thousand hundred and sixteen subjects aged 70 years were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study; 23 POPs were analyzed using high-resolution gas chromatography/high-resolution mass spectrometry. Abdominal magnetic resonance imaging, measuring VAT and SAT, respectively, was performed in a representative subsample of 287 subjects. The less chlorinated polychlorinated biphenyl (PCB) congeners (105 and 118), and the pesticides dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB), and trans-nonachlordane (TNC) were positively related to both VAT and SAT, whereas the more highly chlorinated PCBs (153, 156, 157, 169, 170, 180, 194, 206, and 209) were inversely related to both VAT and SAT. PCB189 was related to the VAT/SAT ratio in an inverted U-shaped manner (P = 0.0008). In conclusion, the results were in accordance with our previous studies using waist circumference and fat mass as obesity measure. However, the novel finding that PCB189 was related to the VAT/SAT ratio deserves further investigation since exposure to this PCB congener, which has previously been linked to diabetes development, might thereby play a role in the distribution of abdominal adipose tissue.
37.	Sandström, Charlotte, et al. (författare) Endovascular plugs to occlude proximal entries in chronic aortic dissection 2022 Ingår i: Interactive Cardiovascular and Thoracic Surgery. - : Oxford University Press (OUP). - 1569-9293 .- 1569-9285. ; 35:3 Tidskriftsartikel (refereegranskat)abstract OBJECTIVES Patients with expanding chronic aortic dissection and patent proximal entries are sometimes poor candidates for open surgery or TEVAR. Occlusion of proximal entries with endovascular plugs has previously been suggested in selected patients, but clinical results over time are unknown. This study analyses aortic remodelling and clinical outcome after proximal entry occlusion. METHODS Between 2007 and 2016, 14 patients, with expanding chronic aortic dissection, considered poor candidates for standard treatment, were treated with endovascular plugs in proximal entries located in the arch (n = 6) or descending aorta (n = 8). The Amplatzer (TM) Vascular Plug II was used for entries <= 4 mm and the Amplatzer (TM) Septal Occluder or Amplatzer (TM) Muscular VSD Occluder for entries 5-16 mm. Patients were followed for 0.5-13 years (median 7.3) with clinical visits and computed tomography. Diameters and cross-sectional areas along the aorta were measured. RESULTS Occlusion of proximal entries was achieved in 10/14 patients (71%), including 4 patients with an adjunctive reintervention needed for complete seal in the segment. Unchanged or reduced maximum thoracic aortic diameter was observed in all 10 patients with successful occlusion. In 4 patients, proximal occlusion was not achieved and early conversion to FET (n = 1), FET/TEVAR (n = 2) or TEVAR (n = 1) was performed. Two aorta-related deaths occurred during follow-up, both after early conversion. CONCLUSIONS Endovascular occlusion of proximal dissection entries of expanding chronic aortic dissections can induce favourable aortic remodelling and may be considered in selected patients with expanding chronic aortic dissection who are poor candidates for open surgery or stent graft repair.
38.	Schrijver, Lieske H, et al. (författare) Oral contraceptive use and ovarian cancer risk for BRCA1/2 mutation carriers : an international cohort study 2021 Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 1097-6868 .- 0002-9378. ; 225:1, s. 1-51 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Ovarian cancer risk in BRCA1 and BRCA2 mutation carriers has been shown to decrease with longer duration of oral contraceptive preparations (OCPs) use. While the effects of OCPs in the general population are well established (∼50% reduction), the estimated risk reduction in mutation carriers is much less precise due to potential bias and small sample sizes. In addition, only a few studies have examined the associations between duration of use, time since last use, starting age, and calendar year of start with risk of ovarian cancer.OBJECTIVE(S): To investigate in more detail the associations between various characteristics of OCP use and risk of ovarian cancer, to provide health care providers and carriers with better risk estimates.STUDY DESIGN: In this international retrospective study, ovarian cancer risk associations were assessed using OCP data on 3,989 BRCA1 and 2,445 BRCA2 mutation carriers. Age-dependent weighted Cox regression analyses were stratified by study and birth cohort and included breast cancer diagnosis as covariate. To minimize survival bias, analyses were left-truncated at 5 years before baseline questionnaire. Separate analysis were conducted for each of the aspects of OCP use and in a multivariate analysis including all these aspects. In addition, the analysis of duration of OCP use was stratified by recency of use.RESULTS: OCPs were less often used by mutation carriers who were diagnosed with ovarian cancer (Ever use: BRCA1 58.6%, BRCA2 53.5%) than by unaffected carriers (Ever use: BRCA1 88.9%, BRCA2 80.7%. The median duration of use was 7 years for both BRCA1 and BRCA2 carriers who developed ovarian cancer, and 9 and 8 years for ovarian cancer unaffected BRCA1 and BRCA2 carriers, respectively. For BRCA1 mutation carriers univariate analyses showed that both a longer duration of OCP use and more recent use of OCPs were inversely associated with risk of ovarian cancer. However, in multivariate analyses including duration of use, age at first use and time since last use, duration of use proved to be the prominent protective factor (compared with <5 years, 5-9 years HR=0.67;95%CI 0.40-1.12, 10+ years HR=0.37;95%CI 0.19-0.73; ptrend=0.008). The inverse association between duration of use and ovarian cancer risk persisted for more than 15 years (Duration of ≥10 years; BRCA1: <15 years since last use: HR=0.24 95%CI 0.14-0.43, 15+ years since last use: HR 0.56 95%CI 0.18-0.59). Univariate results for BRCA2 mutation carriers were similar, but due to limit sample size inconclusive.CONCLUSION: For BRCA1 mutation carriers, a longer duration of OCP use is associated with a greater reduction of ovarian cancer risk and the protection is long term.
39.	Spang, Christoph, et al. (författare) The plantaris tendon in association with mid-portion Achilles tendinosis : tendinosis-like morphological features and presence of a non-neuronal cholinergic system 2013 Ingår i: Histology and Histopathology. - 0213-3911 .- 1699-5848. ; 28, s. 623-632 Tidskriftsartikel (refereegranskat)abstract The plantaris tendon is often neglected in morphological/clinical studies on the lower extremity. There is, however, clinical evidence that the plantaris tendon is involved in cases with Achilles midportion tendinopathy/tendinosis. It is nevertheless unclear if the plantaris tendon exhibits tendinosis-like features in this situation. We therefore investigated the plantaris tendon of patients with midportion Achilles tendinosis when the plantaris tendon was found to be located very close to or invaginated into the Achilles tendon, a situation which very often has been found to be the case. There was a very large number of tenocytes in the tendon tissue and the tenocytes showed abnormal and irregular appearances, exhibiting widened/rounded and wavy appearances, and were frequently lined up in rows. These features are characteristic features in Achilles tendinosis tendons. The tendon cells showed a distinct immunoreaction for the acetylcholine (ACh) -producing enzyme choline acetyltransferase (ChAT). Frequent fibroblasts were found in the loose connective tissue and these cells also showed a marked ChAT immunoreaction. The study shows that the plantaris tendon is morphologically affected in a similar way to the Achilles tendon in cases with midportion Achilles tendinosis and medial pain. The plantaris tendon may accordingly be a co-factor in these cases. The results also favour that there is a local ACh production both within the tendon tissue of the plantaris tendon and in the loose connective tissue. In conclusion, it is evident that plantaris tendons lying invaginated into or very close to the Achilles tendon in cases with midportion Achilles tendinosis show similar tendinosis features, as previously shown for the Achilles tendon itself in these cases.
40.	Strandh, Magnus, et al. (författare) Studies of Interactions with Weak Affinities and Low Molecular Weight Compounds Using Surface Plasmon Resonance Technology 1998 Ingår i: Journal of Molecular Recognition. ; 11, s. 188-190 Tidskriftsartikel (refereegranskat)
41.	Sörelius, Karl, et al. (författare) Endovascular treatment of mycotic aortic aneurysms: a European multicenter study. 2014 Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 1524-4539 .- 0009-7322. ; 130:24, s. 2136-42 Tidskriftsartikel (refereegranskat)abstract Mycotic aortic aneurysm (MAA) is a rare and life-threatening disease. The aim of this European multicenter collaboration was to study the durability of endovascular aortic repair (EVAR) of MAA, by assessing late infection-related complications and long-term survival.
42.	Sörelius, Karl, 1981-, et al. (författare) Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms 2019 Ingår i: European Journal of Vascular and Endovascular Surgery. - : Saunders Elsevier. - 1078-5884 .- 1532-2165. ; 57:2, s. 239-246 Tidskriftsartikel (refereegranskat)abstract Objective: Mycotic aortic aneurysms are rare, life threatening, and complex. This nationwide study aimed to assess outcome after repair of mycotic thoracic aortic aneurysms (MTAAs). Methods: Patients treated in Sweden for MTAAs between 2000 and 2016 were identified in the Swedish vascular registry (2010-16) and local patient registries (2000-09). Primary outcome was survival, and secondary outcomes included surgical strategy, rate of infection related complications (IRC), and re-operations. Results: Fifty-two patients (median age 71 +/- 8.1 years; 28 [54%] men, 13 [25%] ruptured) were identified (3.6% of all thoracic aortic aneurysm repairs in Sweden). Aneurysm location was aortic arch (n = 6; 11%), descending aorta (n = 42; 81%), and multiple locations (n = 4; 8%). Twenty-nine (56%) patients had positive cultures; the most prevalent agent was Staphylococcus aureus (n = 16; 31%). Operative techniques included thoracic endovascular aortic repair (TEVAR; n = 35 [67%]), fenestrated/branched TEVAR (n = 8; 15%), hybrid repair (n = 7; 14%), and open patch repair (n = 2; 4%). Survival was 92% (95% confidence interval [CI] 88-96) at 30 days, 88% (95% CI 84-93) at three months, 78% (73-84) at one year, and 71% (64-77) at five years. The mean follow up among survivors (> 90 days) was 45 months (range 4-216 months). Antibiotics were administered for a median of 15 weeks (range 0-220 weeks). IRCs occurred in nine patients (17%): sepsis (n = 3), graft infection (n = 3), recurrent mycotic aneurysm (n = 1), aorto-oesophageal/bronchial fistula (n = 2). Six (67%) IRCs were fatal; 80% occurred within the first year. Re-operations were performed in nine patients (17%). Conclusions: TEVAR was often used as treatment for MTAAs, with acceptable short- and long-term survival when compared with open cohorts in the literature. IRCs are of concern and warrant follow up and long-term antibiotic treatment.
43.	Vesterbacka, P, et al. (författare) Intercomparison of Rn-222 determination from groundwater 2010 Ingår i: Applied Radiation and Isotopes. - : Elsevier. - 0969-8043 .- 1872-9800. ; 68:1, s. 214-218 Tidskriftsartikel (refereegranskat)abstract An intercomparison exercise on Rn-222 determination in groundwater was organized between eight Nordic laboratories. The individual laboratory results were in most cases within 20% of the median value and within reported uncertainties. Considering the particular difficulties in preparing, transporting and analyzing Rn-222, being a gaseous radionuclide, the results indicate a high analytical capability among the Nordic laboratories. In order to maintain a high analytical quality, similar intercomparisons will also be needed in the future.
44.	Yusuf, Ibtisam, et al. (författare) Particle Size Dependent Dissolution of Uranium Aerosols in Simulated Gastrointestinal Fluids 2023 Ingår i: Health Physics. - : LIPPINCOTT WILLIAMS & WILKINS. - 0017-9078 .- 1538-5159. ; 124:4, s. 285-300 Tidskriftsartikel (refereegranskat)abstract Uranium aerosol exposure can be a health risk factor for workers in the nuclear fuel industry. Good knowledge about aerosol dissolution and absorption characteristics in the gastrointestinal tract is imperative for solid dose assessments and risk management. In this study, an in vitro dissolution model of the GI tract was used to experimentally study solubility of size-fractionated aerosols. The aerosols were collected from four major workshops in a nuclear fuel fabrication plant where uranium compounds such as uranium hexafluoride (UF6), uranium dioxide (UO2), ammonium uranyl carbonate, AUC [UO2CO3 center dot 2(NH4)(2)CO3] and triuranium octoxide (U3O8) are present. The alimentary tract transfer factor, f(A), was estimated for the aerosols sampled in the study. The transfer factor was derived from the dissolution in the small intestine in combination with data on absorption of soluble uranium. Results from the conversion workshop indicated a f(A) in line with what is recommended (0.004) by the ICRP for inhalation exposure to Type M materials. Obtained transfer factors, f(A), for the powder preparation and pelletizing workshops where UO2 and U3O8 are handled are lower for inhalation and much lower for ingestion than those recommended by the ICRP for Type M/S materials f(A) = 0.00029 and 0.00016 vs. 0.0006 and 0.002, respectively. The results for ingestion and inhalation f(A) indicate that ICRPs conservative recommendation of f(A) for inhalation exposure is applicable to both ingestion and inhalation of insoluble material in this study. The dissolution- and subsequent absorption-dependence on particle size showed correlation only for one of the workshops (pelletizing). The absence of correlation at the other workshops may be an effect of multiple chemical compounds with different size distribution and/or the reported presence of agglomerated particles at higher cut points having more impact on the dissolution than particle size. The impact on dose coefficients [committed effective dose (CED) per Bq] of using experimental f(A) vs. using default f(A) recommended by the ICRP for the uranium compounds of interest for inhalation exposure was not significant for any of the workshops. However, a significant impact on CED for ingestion exposure was observed for all workshops when comparing with CED estimated for insoluble material using ICRP default f(A). This indicates that the use of experimentally derived site-specific f(A) can improve dose assessments. It is essential to acquire site-specific estimates of the dissolution and absorption of uranium aerosols as this provides more realistic and accurate dose- and risk-estimates of worker exposure. In this study, the results indicate that ICRPs recommendations for ingestion of insoluble material might overestimate absorption and that the lower f(A) found for inhalation could be more realistic for both inhalation and ingestion of insoluble material.

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