| 1. |
|
|
| 2. |
- Aresdahl, Alexander, et al.
(författare)
-
Congenital granular cell epulis : a case report
- 2015
-
Ingår i: Oral and Maxillofacial Surgery Cases. - : Elsevier BV. - 2214-5419. ; 1:1, s. 8-11
-
Tidskriftsartikel (refereegranskat)abstract
- Congenital granular cell epulis (CGCE) is an uncommon benign lesion found in newborns. It has predominance for females with an 8:1 ratio in relation to males and is exclusively encountered in the oral cavity. The most affected oral site is located around the canine/incisor region of the maxillary alveolar ridge, where the lesion arises from the soft tissue as a solitary pedunculated mass. CGCE's histogenesis remains obscure and controversial. We present a rare case of 2 separate CGCE lesions adjacent to each other measuring 23 × 18 × 10 and 15 × 10 mm, positioned facially on the right maxillary alveolar process. The patient, a 2-day-old female newborn, did not experience any serious difficulty regarding breathing or deglutition. Complete surgical excision was the treatment of choice in this case, and the procedure was performed under both general and local anesthesia. Histologic and immunohistochemical analysis confirmed the diagnosis of CGCE. The patient showed satisfactory postoperative healing and excellent health at both the 10-day recall appointment and the 6-month follow-up.
|
|
| 3. |
- Blache, Ludovic, et al.
(författare)
-
SoftCut: : A Virtual Planning Tool for Soft Tissue Resection on CT Images
- 2018
-
Ingår i: Medical Image Understanding and Analysis. - Cham : Springer. - 9783319959207 ; , s. 299-310
-
Konferensbidrag (refereegranskat)abstract
- With the increasing use of three-dimensional (3D) models and Computer Aided Design (CAD) in the medical domain, virtual surgical planning is now frequently used. Most of the current solutions focus on bone surgical operations. However, for head and neck oncologic resection, soft tissue ablation and reconstruction are common operations. In this paper, we propose a method to provide a fast and efficient estimation of shape and dimensions of soft tissue resections. Our approach takes advantage of a simple sketch-based interface which allows the user to paint the contour of the resection on a patient specific 3D model reconstructed from a computed tomography (CT) scan. The volume is then virtually cut and carved following this pattern. From the outline of the resection defined on the skin surface as a closed curve, we can identify which areas of the skin are inside or outside this shape. We then use distance transforms to identify the soft tissue voxels which are closer from the inside of this shape. Thus, we can propagate the shape of the resection inside the soft tissue layers of the volume. We demonstrate the usefulness of the method on patient specific CT data.
|
|
| 4. |
- Bleiker, Simon J., et al.
(författare)
-
Cost-Efficient Wafer-Level Capping for MEMS and Imaging Sensors by Adhesive Wafer Bonding
- 2016
-
Ingår i: Micromachines. - Basel, Switzerland : Multidisciplinary Digital Publishing Institute (MDPI). - 2072-666X. ; 7:10, s. 192-
-
Tidskriftsartikel (refereegranskat)abstract
- Device encapsulation and packaging often constitutes a substantial part of the fabrication cost of micro electro-mechanical systems (MEMS) transducers and imaging sensor devices. In this paper, we propose a simple and cost-effective wafer-level capping method that utilizes a limited number of highly standardized process steps as well as low-cost materials. The proposed capping process is based on low-temperature adhesive wafer bonding, which ensures full complementary metal-oxide-semiconductor (CMOS) compatibility. All necessary fabrication steps for the wafer bonding, such as cavity formation and deposition of the adhesive, are performed on the capping substrate. The polymer adhesive is deposited by spray-coating on the capping wafer containing the cavities. Thus, no lithographic patterning of the polymer adhesive is needed, and material waste is minimized. Furthermore, this process does not require any additional fabrication steps on the device wafer, which lowers the process complexity and fabrication costs. We demonstrate the proposed capping method by packaging two different MEMS devices. The two MEMS devices include a vibration sensor and an acceleration switch, which employ two different electrical interconnection schemes. The experimental results show wafer-level capping with excellent bond quality due to the re-flow behavior of the polymer adhesive. No impediment to the functionality of the MEMS devices was observed, which indicates that the encapsulation does not introduce significant tensile nor compressive stresses. Thus, we present a highly versatile, robust, and cost-efficient capping method for components such as MEMS and imaging sensors.
|
|
| 5. |
|
|
| 6. |
- Bäcklund, Sofia, et al.
(författare)
-
A Pine Is a Pine and a Spruce Is a Spruce – The Effect of Tree Species and Stand Age on Epiphytic Lichen Communities
- 2016
-
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11
-
Tidskriftsartikel (refereegranskat)abstract
- With an increasing demand for forest-based products, there is a growing interest in introducing fast-growing non-native tree species in forest management. Such introductions often have unknown consequences for native forest biodiversity. In this study, we examine epiphytic lichen species richness and species composition on the trunks of non-native Pinus contorta and compare these to the native Pinus sylvestris and Picea abies in managed boreal forests in northern Sweden across a chronosequence of age classes. Overall, we recorded a total of 66,209 lichen occurrences belonging to 57 species in the 96 studied forest stands. We found no difference in species richness of lichens between stands of P. contorta and P. sylvestris, but stands of P. abies had higher total species richness. However, species richness of lichens in stands of P. abies decreased with increasing stand age, while no such age effect was detected for P. contorta and P. sylvestris. Lichen species composition progressively diverged with increasing stand age, and in 30-year-old stands all three tree species showed species-specific assemblages. Epiphytic lichen assemblages in stands of 30-year-old P. contorta were influenced by greater basal area, canopy closure, and average diameter at breast height, P. abies stands by higher branch density and canopy closure, and stands of P. sylvestris by greater bark crevice depth. Differences in lichen species richness and composition were mainly explained by canopy closure and habitat availability, and the greater canopy closure in mature P. abies stands promoted the colonization and growth of calicioid lichen species. Our results indicate that the non-native P. contorta have similar species richness as the native P. sylvestris. The main difference in lichen species richness and composition is between P. abies and Pinus spp. in managed forests of boreal Sweden.
|
|
| 7. |
- Carlsson, Anders-Petter, et al.
(författare)
-
Surgical pneumatization through maxillary sinus wall and the schneiderian membrane : A new technique to facilitate augmentation of the maxillary sinus.
- 2017
-
Ingår i: Indian Journal of Dental Research. - 0970-9290 .- 1998-3603. ; 28:2, s. 207-208
-
Tidskriftsartikel (refereegranskat)abstract
- A minimum subantral bone height in the posterior maxilla may require a bone augmentation where a sinus lift procedure is the most commonly used technique, either preceding or simultaneously with the implant installation. While elevating the Schneiderian membrane ruptures are common, possibly resulting in less bone formation. In this paper, we propose the surgical pneumatization of the Schneiderian membrane as a new technique to minimize the risk of such complications. This can be achieved mainly by creating a hole for the immediate and increased passage of air through the Schneiderian membrane and the maxillary sinus wall above the region of augmentation.
|
|
| 8. |
- Chrcanovic, Bruno, et al.
(författare)
-
Survival and complications of implants to support craniofacial prosthesis : A systematic review
- 2016
-
Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 44:10, s. 1536-1552
-
Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To assess the survival rate of craniofacial implants (CIs) to support facial prosthesis/epithesis and the prevalence of surgical/biological complications based on previously published studies.METHODS: An electronic search was undertaken in March/2016. Only studies with a minimum of 5 patients were included. Untransformed proportions of implant failures for different regions were calculated. A meta-analysis evaluated the influence of radiotherapy on the failure rates. A meta-regression was performed considering the follow-up period as covariate.RESULTS: Seventy publications included 2355 patients and 8184 CIs (545 failures). The probability of a failure was 5.5% for all CIs (95%CI 4.5-6.5, P < 0.001), 1.2% for CIs in the auricular region (95%CI 0.8-1.5, P < 0.001), 12.2% for the nasal region (95%CI 9.0-15.5, P = 0.017), and 12.1% for the orbital region (95%CI 9.3-15.0, P < 0.001). Radiotherapy statistically affected the CIs rates (OR 5.80, 95%CI 3.77-8.92, P < 0.00001). There was no statistically significant influence of the follow-up time on the proportion of implant failures (P = 0.814). Soft tissue adverse reactions were the most common complications.CONCLUSIONS: Implants placed in the auricular region have a lower probability of failure than those in the nasal and orbital regions. Soft tissue adverse reactions were the most common complications. Radiotherapy significantly affected the CIs failure rates.
|
|
| 9. |
- Danielsson, D., et al.
(författare)
-
Brachytherapy and osteoradionecrosis in patients with base of tongue cancer
- 2023
-
Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 143:1, s. 77-84
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Base of tongue cancer incidence and patient survival is increasing why treatment sequelae becomes exceedingly important. Osteoradionecrosis (ORN) is a late adverse effect of radiotherapy and brachytherapy (BT) could be a risk factor. Brachytherapy is used in three out of six health care regions in Sweden. Aims: Investigate if patients treated in regions using BT show an increased risk for ORN and whether brachytherapy has any impact on overall survival. Material and Methods: We used data from the Swedish Head and Neck Cancer Register between 2008–2014. Due to the nonrandomized nature of the study and possible selection bias we compared the risk for ORN in brachy vs non-brachy regions. Results: Fifty out of 505 patients (9.9%) developed ORN; eight of these were treated in nonbrachy regions (16%), while 42 (84%) were treated in brachy regions. Neither age, sex, TNM-classification/stage, p16, smoking, neck dissection, or chemotherapy differed between ORN and no-ORN patients. The risk for ORN was significantly higher for patients treated in brachy regions compared to non-brachy regions (HR = 2,63, p =.012), whereas overall survival did not differ (HR = 0.95, p =.782). Conclusions and Significance: Brachytherapy ought to be used cautiously for selected patients or within prospective randomized studies.
|
|
| 10. |
- Dasmah, Amir, et al.
(författare)
-
Integration of fluoridated implants in onlay autogenous bone grafts - An experimental study in the rabbit tibia.
- 2014
-
Ingår i: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. - : Elsevier BV. - 1878-4119 .- 1010-5182. ; 42:6, s. 796-800
-
Tidskriftsartikel (refereegranskat)abstract
- Bone augmentation before treatment with endosseous implants is a common procedure for rehabilitation of the edentulous jaw. Both machined and surface modified implants have been used in one-stage and two-stage surgery protocols with varying results and survival rates. The influence of surface modification on the integration of implants has been documented in both non-grafted and grafted bone. The aim of this study was to compare the integration and stability of surface modified fluoridated vs. machined implants when placed simultaneously with an onlay bone graft.
|
|
| 11. |
- Dasmah, Amir, et al.
(författare)
-
Marginal Bone-Level Alterations at Implants Installed in Block versus Particulate Onlay Bone Grafts Mixed with Platelet-Rich Plasma in Atrophic Maxilla. A Prospective 5-Year Follow-Up Study of 15 Patients.
- 2013
-
Ingår i: Clinical implant dentistry and related research. - : Wiley. - 1708-8208 .- 1523-0899. ; 15:1, s. 7-14
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Extensive atrophy of the alveolar process may require a bone-grafting procedure prior to implant treatment. Autogenous bone grafts from the iliac crest, used as onlay block and particulate bone, have been used together with sinus-lift procedure in order to rehabilitate patients with extremely resorbed maxillae. However, there are to our knowledge no 5-year follow-up studies evaluating the extent of bone-level change in patients treated with respectively block and particulate autogenous bone grafts. Purpose: The purpose of this prospective clinical study was to conduct a 5-year follow-up analysis with focus on bone-level alteration in block versus particulate onlay bone grafts. Material and Methods: Fifteen out of originally 19 patients who were treated with iliac bone grafts and oral implants in the maxilla have been followed through the first 5 postoperative years. In a first study conducted on 19 patients, the role of platelet-rich plasma in conjunction with autogenous bone was evaluated. In this 5-year follow-up study, the marginal bone alterations have been documented at base line, 1 year and 5 years of loading to the nearest 0,1mm at mesial and distal surfaces of the implants. Two implants were installed on each side of the midline in either block or particulate bone grafts giving test and control sides in each patient. Additionally, two implants on each side were installed in residual bone/grafted sinus floor. Result: Marginal bone alteration in the anterior maxilla appeared larger at the side augmented by block bone at baseline, and after 1 and 5 years of loading, but the change was not statistically significant. Moreover, there was a significantly higher degree of marginal alteration during the first year of loading, compared with the examinations after 5 years. Conclusion: The present follow-up study showed that there is no significant difference in the extension of resorption between block- and particulate autogenous bone grafts over a 5-year period. Most of the resorption occurred during the first year in function.
|
|
| 12. |
- Dasmah, Amir, et al.
(författare)
-
Particulate vs. block bone grafts : Three-dimensional changes in graft volume after reconstruction of the atrophic maxilla, a 2-year radiographic follow-up
- 2012
-
Ingår i: Journal of Cranio-Maxillofacial Surgery. - : Elsevier BV. - 1010-5182 .- 1878-4119. ; 40:8, s. 654-659
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Extensive alveolar bone resorption in the maxilla limits the possibility of successful placement and osseointegration of endosseous implants for future prosthetic rehabilitation. Autogenous bone from the iliac crest may be used as lateral onlays in the atrophic maxilla, both as block and particulate bone. To our knowledge, there is no three-dimensional 2-year follow-up study measuring the volumetric reduction of the augmented areas comparing particulate and block bone grafts.PURPOSE:The aim of this study was to conduct a radiographic 2-year follow-up study, using computed tomographic (CT) images in order to evaluate and compare the extent of bone graft resorption in the frontal maxillae augmented by particulate (test) and block bone (control).MATERIAL AND METHODS:Eleven patients treated with iliac bone grafts and oral implants in the maxilla were followed with CT examinations directly post grafting and after 2years.RESULT:The volumetric changes after 6months were extensive. Additionally, the changes in particulate bone tended to be larger after 2years compared to block bone, using this protocol. However, the difference was not statistically significant.CONCLUSION:The present follow-up study showed that there is radiographically complete integration and embedding of implants installed in grafted bone despite extensive initial graft resorption. There was no significant difference in the amount of volumetric reduction between particulate bone and block bone grafts.
|
|
| 13. |
- Dasmah, Amir, et al.
(författare)
-
Simultaneous or Delayed Placement of Surface Modified and Fluoridated Dental Implants into Autogenous Block Bone Grafts : A Histologic and Biomechanical Study in the Rabbit
- 2015
-
Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 17:2, s. 395-401
-
Tidskriftsartikel (refereegranskat)abstract
- Background: A delayed approach is recommended for reconstruction of the jaws with autogenous bone grafts and dental implants. Experimental studies have shown stronger bone tissue responses to surface modified implants than to nonmodified ones. AimThe aim of the study was to evaluate bone integration and stability of surface modified and fluoridated implants when placed with fresh or healed autogenous bone grafts. Material and Methods: Six rabbits were used in this study. Each right rabbit tibia (control) received an autogenous bone graft, harvested from the calvarium. Eight weeks later, a second graft was harvested from the other side of the calvarium and placed on the left tibia (test) with an implant. Another implant was installed in the healed graft of the right tibia. TiO2-blasted and fluoridated OsseoSpeed(TM) implants (Astra Tech AB, Molndal, Sweden), 3.5mm in diameter and 9mm long, were used. After additional 8 weeks, the rabbits were sacrificed and the implants were removed en bloc for light-microscopic analysis. Bone-to-implant contact (BIC) was registered as well as the amount of bone filling a rectangle indicating a region of interest (ROI). Resonance frequency analysis (RFA) was conducted both at the time of surgery and at the end of the experiment. ResultsThere were no statistically significant differences either in BIC or ROI between the test and control sides. RFA showed higher implant stability for the control side at the time of the surgery, but the difference had leveled out at the time of the sacrifice. Conclusion: The present study showed similar bone tissue responses and stability for surface modified and fluoridated implants after 8 weeks of healing in fresh or healed autogenous bone grafts.
|
|
| 14. |
- de Lecea, Cristina Gomez-Martinez, et al.
(författare)
-
Five-Step Scapula Tip Flap Harvesting for Oromaxillofacial Defects Reconstruction
- 2022
-
Ingår i: Plastic and reconstructive surgery (1963). - : Ovid Technologies (Wolters Kluwer Health). - 0032-1052 .- 1529-4242. ; 150:2, s. 416e-418e
-
Tidskriftsartikel (refereegranskat)abstract
- In the last 10 years, there has been an increased focus on the scapula tip free flap for head and neck reconstructions. Its several advantages make it a versatile and reliable reconstructive option for patients with orofacial compound defects. The aim of this article is to present a systematic surgical approach for the harvesting of the scapula tip free flap. Herein, a step-by-step surgical approach and some technical tips are described to make the scapula tip flap dissection simpler, safer, and more straightforward.
|
|
| 15. |
- Dérand, Per, et al.
(författare)
-
Glomangioma: a case presentation.
- 2010
-
Ingår i: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. - : Elsevier BV. - 1531-5053 .- 0278-2391. ; 68:1, s. 204-7
-
Forskningsöversikt (refereegranskat)
|
|
| 16. |
- Divakar, Pradeep K., et al.
(författare)
-
Evolution of complex symbiotic relationships in a morphologically derived family of lichen-forming fungi
- 2015
-
Ingår i: New Phytologist. - : Wiley. - 0028-646X .- 1469-8137. ; 208:4, s. 1217-1226
-
Tidskriftsartikel (refereegranskat)abstract
- We studied the evolutionary history of the Parmeliaceae (Lecanoromycetes, Ascomycota), one of the largest families of lichen-forming fungi with complex and variable morphologies, also including several lichenicolous fungi. We assembled a six-locus data set including nuclear, mitochondrial and low-copy protein-coding genes from 293 operational taxonomic units (OTUs). The lichenicolous lifestyle originated independently three times in lichenized ancestors within Parmeliaceae, and a new generic name is introduced for one of these fungi. In all cases, the independent origins occurred c. 24 million yr ago. Further, we show that the Paleocene, Eocene and Oligocene were key periods when diversification of major lineages within Parmeliaceae occurred, with subsequent radiations occurring primarily during the Oligocene and Miocene. Our phylogenetic hypothesis supports the independent origin of lichenicolous fungi associated with climatic shifts at the Oligocene-Miocene boundary. Moreover, diversification bursts at different times may be crucial factors driving the diversification of Parmeliaceae. Additionally, our study provides novel insight into evolutionary relationships in this large and diverse family of lichen-forming ascomycetes.
|
|
| 17. |
- Dunlop, Gordon, et al.
(författare)
-
Examination of the validity of the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale in male professional football players : A worldwide study of 29 professional teams
- 2024
-
Ingår i: Journal of Sports Sciences. - Abingdon, Oxon : Routledge. - 0264-0414 .- 1466-447X. ; , s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Perceived confidence is an important dimension of an athlete’s psychological readiness to return-to-play. However, there is no established and validated tool to evaluate confidence in professional football. This study aimed to provide preliminary evaluation of the internal structure of the Injury-Psychological Readiness to Return-to-Sport scale (I-PRRS) in a cohort of injured male professional footballers. Over an 18-month period, 29 teams from 17 leagues participated. Players sustaining injuries eliciting (Formula presented.) 3 weeks’ time-loss were recruited. Cross culturally adapted to 4 further languages, the I-PRRS was administered on two occasions: 1) day before returning-to-training and 2) day before returning-to-match-play. In total, 113 injuries were recorded with 96 completed I-PRRS data sets collected. Confirmatory factor analysis indicated the I-PRRS was a unidimensional scale, with all items measuring the same construct. The scale demonstrated good internal consistency (ω =.88). When examining longitudinal invariance of the I-PRRS across administration time-points, indices of model fit supported scalar invariance. There was preliminary evidence of good internal structure for the I-PRRS in professional male footballers. However, before further research involving the I-PRRS can be endorsed, efforts to confirm or refute empirical developments pertaining to psychological readiness are necessary. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
|
|
| 18. |
|
|
| 19. |
- Ekelund, Maria, 1970-
(författare)
-
Psoriasis and Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis (JIA) : A Longitudinal Study of the Nordic JIA Cohort
- 2020
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Juvenile idiopathic arthritis, JIA, is used as an umbrella term covering a heterogeneous group of chronic arthritis forms in children, many of which have important differences compared to adult arthritis, while others possibly represent similar diseases among children and adults. Classification aims to give a better understanding of the pathogenesis, patterns, disease trajectories and treatment responses. For the juvenile psoriatic arthritis, JPsA, the classification criteria are currently being debated. The distribution of affected joints in JIA differs greatly and it is unknown why some joints appear to be more affected than others. The temporomandibular joint (TMJ) can be affected early in the course of the disease and often the symptoms are mild and without obvious swelling.This thesis has its origin in the Nordic Study Group of Paediatric Rheumatology and the population-based prospective study of 510 children with newly diagnosed JIA included between 1997 and 1999. Totally 440 children were included in the eight-year follow-up, and in the TMJ study 265 patients were examined and underwent cone-beam computed tomography, CBCT, 17 years after onset.After eight years a considerable proportion of the children with definite psoriasis were classified as undifferentiated JIA based on the exclusion criteria in the ILAR classification. Our data also presents the heterogenicity of JPsA and the development over time of clinical variables supporting a psoriatic diathesis, as well as the overlap between JPsA and enthesitis-related arthritis in a group of patients. We found that extensive symptoms and dysfunctions of the TMJ are seen in JIA 17 years after disease onset, even in patients registered with inactive disease or remission. Individuals with substantial condylar damage on CBCT were found in all JIA categories. The deeper understanding of a chronic disease over time is crucial for research initiatives to improve care as well as for clinical decisions and planning of the health care.Our findings suggest a need for a more appropriate classification of JPsA and also that aspects of TMJ involvement should be included in the general health assessment in JIA.
|
|
| 20. |
- Eriksson, Lars B., et al.
(författare)
-
Intravenous S-ketamine's analgesic efficacy in third molar surgery : A randomized placebo-controlled double-blind clinical trial
- 2023
-
Ingår i: British Journal of Pain. - : Sage Publications. - 2049-4637 .- 2049-4645.
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn most cases, a combination of paracetamol and ibuprofen are the optimal treatment for postoperative pain in third molar surgery. If stronger analgesia is required, opioids are traditionally administered. In day-case, surgery; however, opioids should be avoided. Thus, the anaesthetic agent S-ketamine in analgesic doses might be preferred.MethodsThe study was designed as a randomized placebo-controlled double-blind clinical trial. The study enrolled healthy subjects according to the American Society of Anaesthesiologists classification; I or II (ASA), aged 18 to 44 years, with a body weight between 50 and 100 kg. The patients were randomized into three groups where two doses of S-ketamine were compared (high: 0.25 mg/kg or low: 0.125 mg/kg) with placebo (saline).ResultsA primary outcome of the study was that VAS at 4 h postoperatively, showed no significant difference between the placebo and high-dose S-ketamine group or in the low-dose group. We found a significant difference between the groups for the first 24 h, with a lower VAS-score in the high-dose S-ketamine group. The time to when 50% had taken their first rescue medication was 12 min later in the high-dose ketamine group.ConclusionsPre-emptive S-ketamine 0.25 mg/kg gave a global significant reduction of pain by VAS during the first 24 h postoperatively. The time from end of surgery to first rescue medication were longer in the high-dose ketamine group compared to both low-dose ketamine and placebo groups.
|
|
| 21. |
- Erkapers, Maria, et al.
(författare)
-
Patient satisfaction following dental implant treatment with immediate loading in the edentulous atrophic maxilla
- 2011
-
Ingår i: International Journal of Oral & Maxillofacial Implants. - 0882-2786 .- 1942-4434. ; 26:2, s. 356-364
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The present study evaluated patient satisfaction using the Oral Health Impact Profile 49 (OHIP-49) questionnaire for patients who received six implants in the severely resorbed maxilla and an implant-supported prosthesis that was delivered within 24 hours after surgery. Materials and Methods: Fifty-one edentulous patients with severe atrophy in the maxilla were included in the study, which was performed at two centers. Six implants were placed in the maxilla and loaded within 24 hours with a provisional restoration. The definitive restorations were delivered 20 to 24 weeks later. Patients were asked to complete the OHIP-49 questionnaire (which includes seven domains representing functional limitation, physical pain, psychologic discomfort, physical disability, psychologic disability, social disability, and handicap) prior to implant placement and on three subsequent occasions. The data were collected and analyzed and OHIP scores were compared over time. Results: Baseline satisfaction scores for the two different centers displayed no statistically significant differences. Treatment resulted in improved total OHIP-49 scores in both centers, with no significant difference between centers. Furthermore, no significant differences were observed in any of the individual pretreatment and posttreatment OHIP-49 domains between centers. All seven domains showed a statistically significant improvement posttreatment. Of the seven domains, social disability and handicap showed the least improvement and had the lowest pretreatment scores, indicating lower significance for these domains compared to the other domains during implant treatment. This study also indicated that domains one to five (functional limitation, physical pain, psychologic discomfort, physical disability, and psychologic disability) are the most important domains in patient satisfaction with implant therapy. Conclusion: Measurement with the OHIP-49 questionnaire displayed that patient satisfaction increases after treatment with a fixed restoration on implants loaded within 24 hours.
|
|
| 22. |
- Erkapers, Maria, et al.
(författare)
-
The influence of immediately loaded implant treatment in the atrophic edentulous maxilla on oral health related quality of life of edentulous patients : 3-year results of a prospective study
- 2017
-
Ingår i: Head & Face Medicine. - : Springer Science and Business Media LLC. - 1746-160X. ; 13:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To evaluate oral health related quality of life (OHQoL) in edentulous patients treated with immediately loaded implants in the maxilla.METHODS: Fifty-one edentulous patients in two centers received six maxillary implants each were loaded within 24 h with provisional restoration. Definitive restoration was delivered 20-24 weeks later. OHQoL was evaluated preoperatively with the Oral Health Impact Profile 49 questionnaire (OHIP-49) and on five subsequent occasions. OHIP-49 includes seven domains representing functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. A reduction in OHIP scores indicated an improved OHQoL.RESULTS: Forty-five patients reached the three-year follow up. OHQoL improved after treatment. A plateau of OHQoL improvement was observed at 12 months after surgery. The seven domains improved at different pace, 12 weeks to 12 months after treatment. OHIP showed continuously low scores with no significant changes at consecutive visits 12 months to three years after treatment. Dental status with removable prosthesis in the mandible had a negative impact on OHQoL prior to and during treatment, but did not affect OHQoL after permanent restoration was placed. Patients age or gender did not affect OHQoL.CONCLUSIONS: Patients with edentulous maxilla who received prosthetic rehabilitation on immediately loaded implants experienced the highest improved OHQoL 12 months after implant installation. Quality of life related to oral health continued to be high after three years. Edentulous patients with atrophy of the maxilla experience an improved OHQoL after implant treatment with immediate loading protocol.TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT00711022 .
|
|
| 23. |
|
|
| 24. |
- Franke Stenport, Victoria, 1970, et al.
(författare)
-
Onlay and inlay bone grafts with platelet-rich plasma: histologic evaluations from human biopsies.
- 2011
-
Ingår i: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. - : Elsevier BV. - 1531-5053 .- 0278-2391. ; 69:4, s. 1079-85
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present study was to histomorphometrically evaluate biopsies from 1) sinus inlay bone grafts prepared with or without platelet-rich plasma (PRP) and 2) onlay bone grafts in the anterior maxilla with particulate bone and PRP or block bone without PRP after 3 months.
|
|
| 25. |
|
|
| 26. |
- Frisch, Andreas, et al.
(författare)
-
Additions to the calicioid flora of Japan and Korea, with the descriptions of two new species
- 2014
-
Ingår i: Annales Botanici Fennici. - : Finnish Zoological and Botanical Publishing Board. - 0003-3847 .- 1797-2442. ; 51, s. 189-194
-
Tidskriftsartikel (refereegranskat)abstract
- Two new species of calicioid fungi are described, Phaeocalicium triseptatum Tibell and Sphinctrina intermedia Tibell. While P. triseptatum is only known from Hokkaido, Japan, S. intermedia is known from Hokkaido and Korea. Sphinctrina leucopoda as reported from Korea in the literature is misidentified S. intermedia. The genus Microcalicium is reported as new to Japan with one species, M. arenarium. Phaeocalicium flabelliforme is reported as new to Asia (Japan). Chaenothecopsis savonica is reported as new to Japan and Sphinctrina tubaeformis as new to Hokkaido.
|
|
| 27. |
- Frisch, Andreas, et al.
(författare)
-
Arthonia incarnata (Arthoniaceae), a rare and poorly known old-growth forest lichen new to Asia
- 2017
-
Ingår i: Nordic Journal of Botany. - : Wiley. - 0107-055X. ; 35, s. 587-594
-
Tidskriftsartikel (refereegranskat)abstract
- The rare and poorly known Northern Hemisphere old-growth forest lichen Arthonia incarnata is reported for the first time for Asia from Japan and Korea. A detailed description and illustration is provided for the species based on the collections from Japan and South Korea. Bayesian and RAxML analyses of mtSSU, nLSU and RPB2 sequence data show A. incarnata to be only distantly related to the other Arthonia species hitherto sequenced and in particular to superficially similar species occurring in the same type of habitat such as A. didyma, A. spadicea and A. vinosa. For the analysis we generated new sequence data of A. incarnata for the mtSSU (5 specimens) and RPB2 (5) gene loci. Slight variation was observed in sequence data of the RPB2 gene between collections from eastern Asia and Sweden, but this is not substantiated by differences in morphology or ecological behaviour. Arthonia incarnata is confined to humid forests and only grows on parts of tree trunks shaded from precipitation and running water such as the lower side of leaning trunks or cavities at the base of trees. The species is found on trees with acidic bark, in eastern Asia mainly on Betula but also on coniferous trees and on dead wood. It was not found on bark of Salix (caprea), a common substrate for the species in Europe.
|
|
| 28. |
- Frisch, Andreas, et al.
(författare)
-
Crypthonia, a new genus of byssoid Arthoniaceae (lichenised Ascomycota)
- 2010
-
Ingår i: Mycological Progress. - : Springer Science and Business Media LLC. - 1617-416X .- 1861-8952. ; 9, s. 281-303
-
Tidskriftsartikel (refereegranskat)abstract
- Crypthonia with 11 species is described as belonging to the Arthoniaceae. The new genus is characterised by (1) white to pale carneous, maculiform ascomata lacking a distinct exciple, (2) a weakly gelatinised, hydrophobic hymenium of paraphysoids, (3) a discontinuous layer of branched ascogenous hyphae in the hypothecium, (4) small, clavate to broadly clavate asci of the Arthonia-type lacking a hemiamyloid ring structure in the tholus, (5) eight small, hyaline, 1-3-septate, thin-walled ascospores per ascus, (6) loosely attached thalli with a byssoid, coloured hypothallus, and (7) a chemistry of mainly beta-orcinol depsidones and tridepsides including psoromic, norstictic, and gyrophoric acids. Rugulosin occurs in C. bella and C. citrina. Crypthonia athertoniensis Frisch & G. Thor, C. bella Frisch & G. Thor, C. brevispora Frisch & G. Thor, C. citrina Frisch & G. Thor, C. olivacea Frisch & G. Thor, C. palaeotropica Frisch & G. Thor, and C. vandenboomii Frisch & G. Thor are described. C. albida (F,e) Frisch & G. Thor, C. biseptata (Aptroot & Wolseley) Frisch & G. Thor, C. mycelioides (Vain.) Frisch & G. Thor, and C. polillensis (Vain.) Frisch & G. Thor are new combinations. The delimitation from similar genera and the position within the Arthoniaceae is discussed.
|
|
| 29. |
- Frisch, Andreas, et al.
(författare)
-
Four new Arthoniomycetes from Bwindi Impenetrable National Park, Uganda - supported by molecular data
- 2014
-
Ingår i: Nova Hedwigia. - : Schweizerbart. - 0029-5035 .- 1438-9134. ; 98, s. 295-312
-
Tidskriftsartikel (refereegranskat)abstract
- Arthonia physcidiicola Frisch & G.Thor, Chiodecton sorediatum G.Thor & Frisch, Herpothallon kigeziense Frisch & G.Thor and Reichlingia syncesioides Frisch & G.Thor are described as new to science. All species have been collected in the montane rainforests of Bwindi Impenetrable National Park in south western Uganda. The earlier monotypic genus Reichlingia with one anamorphic species is emended to include three fertile species and is newly reported to Africa. The combinations Reichlingia virginea (Mull.Arg.) Frisch for Arthothelium virgineum Mull.Arg. from the Usambara Mts. in north eastern Tanzania, and Reichlingia zwackhii (Sandst.) Frisch & G.Thor for the European Arthonia zwackhii Sandst. are made. A phylogenetic tree based on Bayesian and ML analyses of combined mtSSU, nLSU and RPB2 data showing the position of the new species in Arthoniomycetes is presented.
|
|
| 30. |
- Frisch, Andreas, et al.
(författare)
-
Galbinothrix, a new monotypic genus of Chrysotrichaceae (Arthoniomycetes) lacking pulvinic acid derivatives
- 2018
-
Ingår i: Plant and Fungal Systematics. - : W. Szafer Institute of Botany Polish Academy of Sciences. - 2544-7459 .- 2657-5000. ; 63, s. 31-37
-
Tidskriftsartikel (refereegranskat)abstract
- Galbinothrix caesiopruinosa is described from Japan and Korea. The new genus and species is placed in Chrysotrichaceae by its ascoma morphology and by a phylogenetic analysis of mtSSU and nLSU sequence data using Bayesian and maximum likelihood inference. The monotypic genus Galbinothrix is superficially similar to Chrysothrix caesia in having dark brown ascomata covered by a thin bluish grey pruina, reddish brown ascomatal pigment in the epithecium and proper exciple, the greyish green to yellowish olive thallus, and usnic acid as the main secondary thallus compound. It differs from this species and all other Chrysotrichaceae by its large, oblong, thick-walled ascospores with a distinct epispore, the narrowly clavate to almost tubular asci, and the never clearly granular to leprose thallus.
|
|
| 31. |
- Frisch, Andreas, et al.
(författare)
-
Herpothallon biacidum, a new lichen species from tropical Australia
- 2010
-
Ingår i: Lichenologist. - 0024-2829 .- 1096-1135. ; 42, s. 285-289
-
Tidskriftsartikel (refereegranskat)abstract
- Herpothallon biacidum Frisch et al. is described from Queensland, tropical Australia. The new species is characterized by a thick byssoid thallus that is loosely attached to the substratum, globular to claviform to short cylindrical pseudoisidia, a brown to brownish black hypothallus, and by the presence of gyrophoric and norstictic acids. This is the first reported co-occurrence of gyrophoric and norstictic acids in the genus. The differences between H. biacidum and other species containing either norstictic acid or gyrophoric acid are discussed. Herpothallon biacidum is also compared with Cryptothecia eungellaeae. Both occur in north Queensland and have the same chemistry, but the latter has a closely adnate thallus and lacks the dark hypothallus and pseudoisidia. The circumscription of Herpothallon and its distinction from Cryptothecia are discussed
|
|
| 32. |
- Frisch, Andreas, et al.
(författare)
-
Herpothallon inopinatum (Arthoniaceae), a new lichen species from Mexico
- 2014
-
Ingår i: Annales Botanici Fennici. - : Finnish Zoological and Botanical Publishing Board. - 0003-3847 .- 1797-2442. ; 51, s. 63-68
-
Tidskriftsartikel (refereegranskat)abstract
- Herpothallon inopinatum Frisch & G. Thor sp. nova (Arthoniaceae) is described from Chiapas, Mexico. It is the second species of Herpothallon known with mature ascospores besides H. fertile. It differs from H. fertile in smaller asci immersed in the thallus instead of strongly protruding barrel-shaped thallus warts, smaller bean-shaped Herpothallon inopinatum most closely resembles H. pustulatum, but differs in the absence of pustules. The closely related H. rubrocinctum has distinct bright-red pseudoisidia and a bright-red pigmentation of pro- and hypothallus, while H. inopinatum lacks pseudoisidia and has a pro- and hypothallus white mottled pale yellow to orange to purplish brown. A revised key to all 34 currently accepted species in Herpothallon is provided.
|
|
| 33. |
- Frisch, Andreas, et al.
(författare)
-
Herpothallon rubroechinatum (Arthoniaceae), a new species from tropical and subtropical America
- 2010
-
Ingår i: Bryologist. - : American Bryological and Lichenological Society. - 0007-2745. ; 113, s. 144-148
-
Tidskriftsartikel (refereegranskat)abstract
- Herpothallon rubroechinatum is described from the U.S.A. (Florida), Costa Rica and Peru. The new species is characterised by scattered red anthraquinone crystals being attached to hyphae projecting from the thallus, the globose to cylindrical pseudoisidia, a closely adnate thallus, and psoromic acid as the main lichen compound; pycnidia are common at the tips of the pseudoisidia. The medulla of the new species shows a patchily distributed amyloid reaction. Contrary to previous reports, the amyloidity of the medulla was observed in all Herpothallon species re-investigated during this study. H. rubroechinatum is compared to the two other red pigmented species that contain psoromic acid, H. australasicum that lacks pigment crystals on the pseudoisidia, and H. globosum that has a loosely attached thallus and a well developed red hypothallus.
|
|
| 34. |
- Frisch, Andreas, et al.
(författare)
-
Inoderma and related genera in Arthoniaceae with elevated white pruinose pycnidia or sporodochia
- 2015
-
Ingår i: Lichenologist. - 0024-2829 .- 1096-1135. ; 47, s. 233-256
-
Tidskriftsartikel (refereegranskat)abstract
- The genus Inoderma (Ach.) Gray is lectotypified with Inoderma byssaceum and resurrected for a small group of species in Arthoniaceae with elevated, white pruinose pycnidia, immersed to adnate white pruinose apothecia and a weakly gelatinized hymenium. Inoderma nipponicum is described from Japan, I. afromontanum from Uganda and the European Lecanactis subabietina is transferred to the genus. Sporodophoron is described for a small group of species in Arthoniaceae related to Inoderma but with a unique type of sporodochia instead of pycnidia. Sterile specimens of this new genus resemble species of Tylophoron but differ in the rounded angular to elliptical to short cylindrical, 0-2-septate sporodochial conidia with unevenly thickened walls which are formed apically in zigzag-shaped and occasionally branched chains. Sporodophoron further differs in thallus chemistry and is genetically distinct. Tylophoron americanum and Schismatomma cretaceum are transferred to Sporodophoron, and the new species S. gossypinum from Japan and S. primorskiense from eastern Russia are described. The genus Glomerulophoron is described for a single species from Mauritius, G. mauritiae, differing from Sporodophoron in the tightly coiled chains of sporodochial conidia and being genetically distinct. A phylogenetic tree showing the position of Inoderma, Sporodophoron and Glomerulophoron in Arthoniaceae is presented. A key to all species of Arthoniaceae with sporodochia or elevated white pruinose pycnidia is presented. Arthothelium spectabile, the type of the large heterogeneous genus Arthothelium, is confirmed for the cryptothecioid subclade in Arthoniaceae.
|
|
| 35. |
- Frisch, Andreas, et al.
(författare)
-
Lichenicolous fungi from Japan and Korea: new species, new records and a first synopsis for Japan
- 2015
-
Ingår i: Herzogia. - : Herzogia. - 0018-0971. ; 28, s. 762-789
-
Tidskriftsartikel (refereegranskat)abstract
- Sixty six species of lichenicolous fungi are reported from Japan and eight species from South Korea. The new genus Caeruleoconidia is introduced, and four species, Caeruleoconidia ochrolechiae, Diplolaeviopsis japonica, Perigrapha lobariae and Skyttea ochrolechiae, are described as new to science. The new combination Lichenosticta lecanorae is introduced and a neotype designated for this taxon. Buelliella cf. inops, Cercidospora stenotropae, Cladophialophora parmeliae, Endococcus cf. brachysporus, Lichenosticta lecanorae, Micarea inquinans, Minutoexcipula cf. mariana, Protounguicularia nephromatis, Polycoccum hymeniicola, Stigmidium alectoriae and Tephromela campestricola are new to Asia, another 18 species are second reports for Asia. Sixty-one species are new to Japan and eight species new to South Korea. Nephroma is a new host genus for Hainesia aeruginascens and Vulpicida for Muellerella lichenicola. A first synopsis of the lichenicolous fungi of Japan including 95 species is presented, which presumably covers less than 30 % of the total diversity of lichenicolous fungi in that country.
|
|
| 36. |
- Frisch, Andreas, et al.
(författare)
-
Phylogenetic status of Arthonia phaeophysciae (Arthoniaceae, Ascomycota), a species new to Japan
- 2020
-
Ingår i: Shokubutsu kenkyū zasshi. - 0022-2062. ; 95, s. 133-140
-
Tidskriftsartikel (refereegranskat)abstract
- The lichenicolous fungus Arthonia phaeophysciae Grube & Matzer (Arthoniaceae, Ascomycota), growing on Physciella melanchra and Phaeophyscia sp., is newly reported from Central Honshu in Japan. Additional localities are reported for Korea. This study demonstrates the phylogenetic position of the species in the Bryostigma-clade of Arthoniaceae and confirms the identity of this research’s recent collections from Japan and Korea using Bayesian and RAxML analyses of mtSSU, nrLSU and RPB2 sequence data. A detailed description of the species based on collections from Japan and Korea is provided.
|
|
| 37. |
|
|
| 38. |
- Frisch, Andreas, et al.
(författare)
-
The Arthonialean challenge: Restructuring Arthoniaceae
- 2014
-
Ingår i: Taxon. - : Wiley. - 0040-0262 .- 1996-8175. ; 63, s. 727-744
-
Tidskriftsartikel (refereegranskat)abstract
- The Arthoniales is the second-largest group of lichen-forming fungi. A new phylogeny of Arthoniales based on mtSSU, nLSU and RPB2 sequence data is presented, with a focus on crustose representatives. A total of 145 taxa are analyzed including 64 species of Arthoniaceae. We obtained 198 new sequences for 83 specimens representing 71 taxa of Arthoniales. Arthoniaceae is recovered as polyphyletic, demonstrating that previous classifications do not reflect evolutionary patterns. Three phylogenetic lineages are identified: the Arthoniaceae clade, the Bryostigma clade and the Felipes clade. The Bryostigma clade is related to Arthoniaceae, while the Felipes clade shows close affinities to Chrysotrichaceae. Cryptotheciaceae is included as a paraphyletic grouping in Arthoniaceae. Lecanographaceae and the genera Felipes and Melarthonis are described. Bryostigma and Pachnolepia are reinstated for former Arthonia species, and Myriostigma for the Cryptothecia candida complex. Fouragea is reinstated for foliicolous Opegrapha species. Arthonia eos is described and the new combination Alyxoria mougeotii is made. A lectotype is selected for Spiloma fallax. Melaspilea granitophila belongs in Arthoniaceae and Arthonia mediella in Chrysotrichaceae. According to the phylogenetic hypothesis, lichen secondary chemistry, such as pulvinic acid derivates or red pigments, does not characterize monophyletic groups above the genus level. The parasitic life style in Arthoniaceae has evolved more than once. Parasitic species are found in four lineages of the Arthoniaceae clade and in the Bryostigma clade. Arthoniomycetes with chlorococcoid photobionts are restricted to the Bryostigma clade and Chrysotrichaceae, while the only saprophytic Arthonia species in the phylogeny are related to Arthonia radiata and group with lichenized taxa. The phylogenetic data provide a coherent framework for delineating further monophyletic groups in Arthoniaceae in the future.
|
|
| 39. |
- Frisch, Andreas, et al.
(författare)
-
Tree Species Composition Predicts Epiphytic Lichen Communities in an African Montane Rain Forest
- 2015
-
Ingår i: Biotropica. - : Wiley. - 0006-3606. ; 47, s. 542-549
-
Tidskriftsartikel (refereegranskat)abstract
- The ecology of many tropical rain forest organisms, not the least in Africa, remains poorly understood. Here, we present a detailed ecological study of epiphytic lichens in the equatorial montane rain forest of Bwindi National Park (331km(2)), Uganda. We evaluated all major lichen growth forms, including selected groups of crustose lichens. In 14 transects at elevations of 1290m to 2500m, we sampled 276 trees belonging to 60 species. We recorded all lichen species on each tree trunk between ground level and 2m above the ground, yielding 191 lichen species in 67 genera, with a mean of 4.7 species per tree. We used non-metric multi-dimensional scaling to separate epiphytic lichen assemblages according to tree species composition and elevation. Structural equation modeling indicated that elevation influenced tree species composition and that tree species composition largely determined lichen species composition. Thus, elevation acted indirectly on the lichen assemblages. Further studies examining factors such as bark properties and lichen colonization ecology may clarify what determines the association between tree species and lichen assemblages. The link between lichen assemblages and large-scale elevation patterns, as well as disturbance and regrowth histories, warrants further study. An analysis of lichen species composition on individual tree species that occur over large elevation ranges would distinguish the effect of tree species on lichen assemblages from the effect of elevation and thus climate. Our study highlights the limited extent of our knowledge of tropical epiphytic lichens.
|
|
| 40. |
- Galderisi, Maurizio, et al.
(författare)
-
Standardization of adult transthoracic echocardiography reporting in agreement with recent chamber quantification, diastolic function, and heart valve disease recommendations : an expert consensus document of the European Association of Cardiovascular Imaging
- 2017
-
Ingår i: European Heart Journal Cardiovascular Imaging. - : OXFORD UNIV PRESS. - 2047-2404 .- 2047-2412. ; 18:12, s. 1301-1310
-
Tidskriftsartikel (refereegranskat)abstract
- Aims This European Association Cardiovascular Imaging (EACVI) Expert Consensus document aims at defining the main quantitative information on cardiac structure and function that needs to be included in standard echocardiographic report following recent ASE/EACVI chamber quantification, diastolic function, and heart valve disease recommendations. The document focuses on general reporting and specific pathological conditions such as heart failure, coronary artery and valvular heart disease, cardiomyopathies, and systemic diseases. Methods and results Demographic data (age, body surface area, blood pressure, and heart rhythm and rate), type (vendor and model) of ultrasound system used and image quality need to be reported. In addition, measurements should be normalized for body size. Reference normal values, derived by ASE/EACVI recommendations, shall always be reported to differentiate normal from pathological conditions. This Expert Consensus document suggests avoiding the surveillance of specific variable using different ultrasound techniques (e.g. in echo labs with high expertise in left ventricular ejection fraction by 3D and not by 2D echocardiography). The report should be also tailored in relation with different cardiac pathologies, quality of images, and needs of the caregivers. Conclusion The conclusion should be concise reflecting the status of left ventricular structure and function, the presence of left atrial and/or aortic dilation, right ventricular dysfunction, and pulmonary hypertension, leading to an objective communication with the patient health caregiver. Variation over time should be considered carefully, taking always into account the consistency of the parameters used for comparison.
|
|
| 41. |
|
|
| 42. |
- Gremyr, Andreas, et al.
(författare)
-
How a Point-of-Care Dashboard Facilitates Co-production of Health Care and Health for and with Individuals with Psychotic Disorders : A Mixed-methods Case Study
- 2022
-
Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundIndividuals with psychotic disorders experience widespread treatment failures and risk early death. Sweden’s largest department specializing in psychotic disorders sought to improve patients’ health by developing a point-of-care dashboard to support joint planning and co-production of care. The dashboard was tested for 18 months and included more than 400 patients at two outpatient clinics.MethodsThis study evaluates the dashboard by addressing two questions:Can differences in health-related outcome measures be attributed to the use of the dashboard?How did the case managers experience the accessibility, use, and usefulness of the dashboard for co-producing care with individuals with psychotic disorders? This mixed-method case study used both Patient-Reported Outcome Measures (PROM) and data from a focus group interview with case managers. Data collection and analysis were framed by the Clinical Adoption Meta Model (CAMM) phases: i) accessibility, ii) system use, iii) behavior, and iv) clinical outcomes. The PROM used was the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0), which assesses functional impairment and disability. Patients at clinics using the dashboard were matched with patients at clinics not using the dashboard. PROM data were compared using non-parametric statistics due to skewness in distribution. The focus group included five case managers who had experience using the dashboard with patients.ResultsCompared to patients from clinics that did not use the dashboard, patients from clinics that did use the dashboard improved significantly overall (p = 0.045) and in the domain self-care (p = 0.041). Focus group participants reported that the dashboard supported data feedback-informed care and a proactive stance related to changes in patients’ health. The dashboard helped users identify critical changes and enabled joint planning and evaluation.ConclusionDashboard use was related to better patient health (WHODAS scores) when compared with matched patients from clinics that did not use the dashboard. In addition, case managers had a positive experience using the dashboard. Dashboard use might have lowered the risk for missing critical changes in patients’ health while increasing the ability to proactively address needs. Future studies should investigate how to enhance patient co-production through use of supportive technologies.
|
|
| 43. |
- Gremyr, Andreas
(författare)
-
Improving health with and for individuals with schizophrenia using a learning health system approach : From idea to daily practice
- 2022
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psychotic disorders like schizophrenia have a typical onset in early adulthood with symptoms of hallucinations and disturbances of thought. Despite knowledge on what constitutes effective schizophrenia care, more than 70% of treatment attempts fail in Sweden, sometimes leading to early death. An appraisal of schizophrenia care shows a lack of ways to jointly plan and evaluate care, and an absence of a trustworthy theory-of-change. The Learning Health System (LHS) is a vision that has been translated into theories and models associated with improved outcomes for patients with other chronic conditions. The aim of this thesis is to enhance the understanding of the applicability of the LHS vision in the context of schizophrenia care, from the perspectives of both individuals and the health system in enabling coproduction of better health by addressing two research questions:i) How can improvement of health for individuals with schizophrenia and improvement of system performance be supported by coproduction in an LHS model?ii) Can an LHS-based intervention, i.e. the use of a point of care dashboard, contribute to better health for individuals with schizophrenia?Studying the existing published knowledge of LHS show that the concept has not yet been applied in mental healthcare settings but has potential to increase patient coproduction, continuous improvement and better health. Different forms of coproduction are supported in the most comprehensive LHS models and applications, ranging from dashboards at point of care to platforms that can help facilitate improvement initiatives.A case study, focused on studying the use and usefulness of a point-of-care dashboard at patient visits in outpatient care at the Department of Schizophrenia Spectrum Disorders at Sahlgrenska University Hospital in western Sweden. Use of the dashboard is associated with improved communication and health for patients. Assessment of the dashboard-project’s complexity using the Non-adoption, abandonment, scale-up, spread and sustainability complexity assessment tool (NASSS-CAT) was perceived as helpful in evaluating challenges and provided insight that can guide future development. An LHS model, that builds on both the reviewing of the literature and practical testing, is proposed.Further research is proposed in two areas, exploration of how dashboard initiatives can support coproduction and better health for individuals with complex chronic conditions and further development of LHS models by studying different LHS initiatives regarding system properties, forms of coproduction at play and effects on health outcomes for individuals and populations.
|
|
| 44. |
- Gremyr, Andreas, et al.
(författare)
-
The role of co-production in Learning Health Systems
- 2021
-
Ingår i: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 33:Supplement 2, s. ii26-ii32
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Co-production of health is defined as 'the interdependent work of users and professionals who are creating, designing, producing, delivering, assessing, and evaluating the relationships and actions that contribute to the health of individuals and populations'. It can assume many forms and include multiple stakeholders in pursuit of continuous improvement, as in Learning Health Systems (LHSs). There is increasing interest in how the LHS concept allows integration of different knowledge domains to support and achieve better health. Even if definitions of LHSs include engaging users and their family as active participants in aspects of enabling better health for individuals and populations, LHS descriptions emphasize technological solutions, such as the use of information systems. Fewer LHS texts address how interpersonal interactions contribute to the design and improvement of healthcare services.OBJECTIVE: We examined the literature on LHS to clarify the role and contributions of co-production in LHS conceptualizations and applications.METHOD: First, we undertook a scoping review of LHS conceptualizations. Second, we compared those conceptualizations to the characteristics of LHSs first described by the US Institute of Medicine. Third, we examined the LHS conceptualizations to assess how they bring four types of value co-creation in public services into play: co-production, co-design, co-construction and co-innovation. These were used to describe core ideas, as principles, to guide development.RESULT: Among 17 identified LHS conceptualizations, 3 qualified as most comprehensive regarding fidelity to LHS characteristics and their use in multiple settings: (i) the Cincinnati Collaborative LHS Model, (ii) the Dartmouth Coproduction LHS Model and (iii) the Michigan Learning Cycle Model. These conceptualizations exhibit all four types of value co-creation, provide examples of how LHSs can harness co-production and are used to identify principles that can enhance value co-creation: (i) use a shared aim, (ii) navigate towards improved outcomes, (iii) tailor feedback with and for users, (iv) distribute leadership, (v) facilitate interactions, (vi) co-design services and (vii) support self-organization.CONCLUSIONS: The LHS conceptualizations have common features and harness co-production to generate value for individual patients as well as for health systems. They facilitate learning and improvement by integrating supportive technologies into the sociotechnical systems that make up healthcare. Further research on LHS applications in real-world complex settings is needed to unpack how LHSs are grown through coproduction and other types of value co-creation.
|
|
| 45. |
- Gremyr, Andreas, et al.
(författare)
-
Using Complexity Assessment to Inform the Development and Deployment of a Digital Dashboard for Schizophrenia Care: Case Study
- 2020
-
Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 22:4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Health care is becoming more complex. For an increasing number of individuals, interacting with health care means addressing more than just one illness or disorder, engaging in more than one treatment, and interacting with more than one care provider. Individuals with severe mental illnesses such as schizophrenia are disproportionately affected by this complexity. Characteristic symptoms can make it harder to establish and maintain relationships. Treatment failure is common even where there is access to effective treatments, increasing suicide risk. Knowledge of complex adaptive systems has been increasingly recognized as useful in understanding and developing health care. A complex adaptive system is a collection of interconnected agents with the freedom to act based on their own internalized rules, affecting each other. In a complex health care system, relevant feedback is crucial in enabling continuous learning and improvement on all levels. New technology has potential, but the failure rate of technology projects in health care is high, arguably due to complexity. The Nonadoption, Abandonment, and challenges to Scale-up, Spread, and Sustainability (NASSS) framework and complexity assessment tool (NASSS-CAT) have been developed specifically to help identify and manage complexity in technology-related development projects in health care. Objective: This study aimed to use a pilot version of the NASSS-CAT instrument to inform the development and deployment of a point-of-care dashboard supporting schizophrenia care in west Sweden. Specifically, we report on the complexity profile of the project, stakeholders' experiences with using NASSS-CAT, and practical implications. Methods: We used complexity assessment to structure data collection and feedback sessions with stakeholders, thereby informing an emergent approach to the development and deployment of the point-of-care dashboard. We also performed a thematic analysis, drawing on observations and documents related to stakeholders' use of the NASSS-CAT to describe their views on its usefulness. Results: Application of the NASSS framework revealed different types of complexity across multiple domains, including the condition, technology, value proposition, organizational tasks and pathways, and wider system. Stakeholders perceived the NASSS-CAT tool as useful in gaining perspective and new insights, covering areas that might otherwise have been neglected. Practical implications derived from feedback sessions with managers and developers are described. Conclusions: This case study shows how stakeholders can identify and plan to address complexities during the introduction of a technological solution. Our findings suggest that NASSS-CAT can bring participants a greater understanding of complexities in digitalization projects in general.
|
|
| 46. |
- Guillet, Claire, et al.
(författare)
-
Bone formation beyond the skeletal envelope using calcium phosphate granules packed into a collagen pouch-a pilot study
- 2023
-
Ingår i: Biomedical Materials. - : Institute of Physics Publishing (IOPP). - 1748-6041 .- 1748-605X. ; 18:3
-
Tidskriftsartikel (refereegranskat)abstract
- In this proof-of-concept, bone neoformation beyond the skeletal envelope is explored by using a collagen pouch (n = 6) packed with calcium phosphate (CaP) granules placed over the frontal bone in sheep (n = 3). At 13 weeks, macroscopic examination showed specimens covered by an adherent fibrinous envelope with slight vascularization. Histology revealed colonization of the implant by newly formed woven bone and fibrous connective tissue. Surface osteoblasts as well as material-filled macrophages, lymphocytes, polymorphonuclear cells and giant cells were also found in large quantities surrounding the newly formed bone tissue inside the collagen pouch. On the side facing the recipient bone, the collagen membrane had to a large extent been resorbed and bridging bone formation was clearly visible between the test article and recipient bone. On the other side facing soft tissue, the collagen pouch remained intact with a visible fibrous capsule. This study demonstrated that the use of a collagen sleeve as a container for CaP granules allows for good neoformation beyond the skeletal envelope with bridging bone formation clearly visible between the test article and recipient bone. Additionally, in this model, macrophages rather than osteoclasts appear to modulate CaP granule resorption and remodeling into new bone. This construct opens new perspectives for treatment methods that could be used for bone augmentation and restoration of cranio-maxillofacial defects and malformations.
|
|
| 47. |
- Hallman, Mats, et al.
(författare)
-
Bone substitutes and growth factors as an alternative/complement to autogenous bone for grafting in implant dentistry
- 2008
-
Ingår i: Periodontology 2000. - : Wiley. - 0906-6713 .- 1600-0757. ; 47:1, s. 172-92
-
Tidskriftsartikel (refereegranskat)abstract
- Autogenous bone, with its osteogenic, osteoinductive and osteoconductive properties, has long been considered the ideal grafting material in bone reconstructive surgery (26, 85). However, drawbacks with autogenous bone include morbidity, availability and unpredictable graft resorption (85, 93, 94, 128, 167, 174). Recent advances in biotechnology have provided the implant surgeon with access to a great variety of bone grafting materials and the possibility of easier implant treatment for the patient as well as for the surgeon. However, the perfect grafting material has yet to be identified. Current research focuses on proteins and carriers for delivering growth factors to the surgical site; however, drawbacks of high production costs and unpredictable results exist. The clinical usefulness of a great variety of materials for bone augmentation in implant dentistry has been seriously questioned (56). The use of osteconductive osteobiologics in implant dentistry remains an experimental procedure until more knowledge becomes available regarding the clinical and biologic aspects of these materials. Osteoinduction denotes a process of accelerated bone formation that provides an abbreviated healing period. Using solely an osteoconductive grafting material may prolong the healing period with 2–6 months, which may be of clinical significance. Uncontrolled case reports, which suggest a graft healing period of 3–4 months for osteoconductive deproteinized bovine bone or biphasic materials, may mislead the inexperienced dentist. Furthermore, clinical recommendations seem premature when based upon a few animal studies rather than upon comprehensive long-term investigations in humans. This review discusses clinical studies of bone substitutes, growth factors and bone graft procedures employed with the purpose of augmenting periimplant sites.
|
|
| 48. |
- Hammarfjord, Oscar, et al.
(författare)
-
Surgical treatment of recurring ameloblastoma, are there options?
- 2013
-
Ingår i: British Journal of Oral & Maxillofacial Surgery. - : Elsevier BV. - 0266-4356 .- 1532-1940. ; 51:8, s. 762-766
-
Tidskriftsartikel (refereegranskat)abstract
- Our aim was to evaluate the treatment given to patients with intraosseus ameloblastomas with special emphasis on recurrence and the outcomes of primary and secondary resection. Forty-eight patients who were treated for intraosseous ameloblastoma at 8 centres across Sweden met the inclusion criteria. They showed typical distribution of age, sex, site of lesion, and characteristic presenting features. Eleven of the 48 were initially treated with radical resection and none recurred. Twenty-two of the remaining 37 who were initially treated by conservative resection presented with recurrences. Sixteen of the 22 then had conservative secondary resections, which resulted in further recurrence in 6 patients. Initial radical resection is therefore superior to conservative management as far as recurrences are concerned. We argue, however, that a conservative surgical approach is adequate for many intraosseous ameloblastomas with limited extension, because relapse can be followed by radical resection if clinically indicated in selected cases.
|
|
| 49. |
- Hashemi, Helya, et al.
(författare)
-
Localized IgG4-related disease manifested on the tongue : a case report
- 2021
-
Ingår i: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 126:1
-
Tidskriftsartikel (refereegranskat)abstract
- Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory condition that can affect multiple organs. IgG4-RD may show a variety of initial symptoms. In the oral mucosa, lesions present as inflammatory fibrosis with a large number of IgG4-positive plasma cells. Evaluating treatment is a well-known problem in IgG4-RD due to the absence of an established assessment system. There are difficulties in defining the severity of the disease, which is why treatment is primarily based on its clinical manifestations. We present a case report of localized IgG4-RD with ulcerative and proliferative manifestations on the tongue, which clinically mimicked oral squamous cell carcinoma. A tumor-like lesion on the tongue can indicate something else other than the malignant or reactive changes commonly found in the oral mucosa. Multiple differential diagnoses of these atypical oral lesions, including localized IgG4-RD, should be considered.
|
|
| 50. |
- Hedenqvist, Patricia, et al.
(författare)
-
Carprofen neither reduces postoperative facial expression scores in rabbits treated with buprenorphine nor alters long term bone formation after maxillary sinus grafting
- 2016
-
Ingår i: Research in Veterinary Science. - : Elsevier BV. - 0034-5288 .- 1532-2661. ; 107, s. 123-131
-
Tidskriftsartikel (refereegranskat)abstract
- In connection with bilateral maxillary sinus augmentation, the acute effects of the nonsteroidal anti-inflammatory drug carprofen on facial expressions and long-term effects on bone formation were evaluated in 18 male New Zealand White rabbits. A 10 x 10 mm bone window was drilled in the maxilla, the sinus membrane elevated and a titanium mini-implant inserted. One of two test materials was randomly inserted unilaterally and bovine bone chips (control) on the contralateral side in the created space. Rabbits were randomly allocated to receive buprenorphine plus carprofen (n = 9) or buprenorphine plus saline (n = 9) postoperatively. Buprenorphine was administered subcutaneously every 6 h for 3 days in a tapered dose (0.05-0.01 mg/kg) and carprofen (5 mg/kg) or saline administered subcutaneously 1 h before, and daily for 4 days postoperatively. To assess pain, clinical examination, body weight recording and scoring of facial expressions from photos taken before, and 6-13 h after surgery were performed. Twelve weeks after surgery the rabbits were euthanized and sections of maxillary bones and sinuses were analysed with histomorphometry and by qualitative histology. Carprofen had no effect on mean facial expression scores, which increased from 0.0 to 3.6 (carprofen) and 43 (saline), of a maximum of 8.0. Neither did carprofen have an effect on bone formation or implant incorporation, whereas the test materials had. In conclusion, treatment with 5 mg/kg carprofen once daily for 5 days did not reduce facial expression scores after maxillary sinus augmentation in buprenorphine treated rabbits and did not affect long term bone formation.
|
|
