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| 2. |
- Skrifvars, M. B., et al.
(författare)
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Do patient characteristics or factors at resuscitation influence long-term outcome in patients surviving to be discharged following in-hospital cardiac arrest?
- 2007
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Ingår i: J Intern Med. - : Wiley. - 0954-6820 .- 1365-2796. ; 262:4, s. 488-95
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Tidskriftsartikel (refereegranskat)abstract
- Introduction. Few studies have focused on factors influencing long-term outcome following in-hospital cardiac arrest. The present study assesses whether long-term outcome is influenced by difference in patient factors or factors at resuscitation. Methods. An analysis of cardiac arrest data collected from one Swedish tertiary hospital and from five Finnish secondary hospitals supplemented with data on 1 year survival. Multiple logistic regression analysis was used to identify factors associated with survival at 12 months. Results. A total of 441 patients survived to hospital discharge following in-hospital cardiac arrest and 359 (80%) were alive at 12 months. Factors independently associated with survival [odds ratio (OR) >1 indicates increased survival and <1 decreased survival] at 12 months were; age [OR 0.95, 95% confidence interval (CI) 0.93-0.98], renal disease (OR 0.3, CI 0.1-0.9), good functional status at discharge (OR 4.9, CI 1.3-18.9), arrest occurring at (compared with arrests on general wards) emergency wards (OR 4.7, CI 1.4-15.3), cardiac care unit (OR 2.8, CI 1.2-6.4), intensive care unit (OR 2.4, CI 1.1-5.7), ward for thoracic surgery (OR 10.2, CI 2.6-40.1) and unit for interventional radiology (OR 13.3, CI 3.4-52.0). There was no difference in initial rhythm, delay to defibrillation or delay to return of spontaneous circulation between survivors and nonsurvivors. Conclusion. Several patient factors, mainly age, functional status and co-morbid disease, influence long-term survival following cardiac arrest in hospital. The location where the arrest occurred also influences survival, but initial rhythm, delay to defibrillation and to return of spontaneous circulation do not.
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| 3. |
- Skrifvars, M. B., et al.
(författare)
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Variability in survival after in-hospital cardiac arrest depending on the hospital level of care
- 2007
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Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 73:1, s. 73-81
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Survival after in-hospital cardiac arrest (IHCA) differs considerably between hospitals. This study tries to determine whether this difference is due to patient selection because of the hospital level of care or to effective resuscitation management. METHODS: Prospectively collected data on management of in-hospital cardiac arrests from Sahlgrenska Hospital, a tertiary hospital in Gothenburg, Sweden (cohort one) and from five Finnish secondary hospitals (cohort two). A multiple logistic regression model was created for predicting survival to hospital discharge. RESULTS: A total of 954 cases from Sahlgrenska Hospital and 624 patients from the hospitals in Finland were included. The delay to defibrillation was longer at Sahlgrenska than at the five Finnish secondary hospitals (p=0.045). Significant predictors of survival were: (1) age below median (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.5-2.8); (2) no diabetes (OR 1.9, CI 1.2-2.9); (3) arrests occurring during office hours (OR 1.5, CI 1.1-2.2); (4) witnessed cardiac arrest (OR 6.3, CI 2.6-15.3); (5) ventricular fibrillation or ventricular tachycardia as the initial rhythm (OR 4.9, CI 3.5-6.7); (6) location of the arrest (compared to arrests in general wards, GW): thoracic surgery and heart transplantation ward (OR 2.9, CI 1.5-5.9), interventional radiology (OR 4.8, CI 1.9-12.0) and other in-hospital locations (3.0, CI 1.6-5.7) and (7) hospital (compared to arrests at Sahlgrenska Hospital); arrests at Etela-Karjala Central Hospital [CH] (OR 0.3, CI 0.1-0.7), Paijat-Hame CH (OR 0.3, CI 0.1-0.8) and Seinajoki CH (OR 0.4, CI 0.3-0.7). CONCLUSION: The comparison of survival following IHCA between different hospitals is difficult, there seems to be undefined factors greatly associated with outcome. A great variability in survival within different hospital areas probably because of differences in patient selection, patient surveillance and resuscitation management was also noted. A locally implemented strong in-hospital chain of survival is probably the only way to improve outcome following IHCA.
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| 4. |
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| 5. |
- Akselsen, Odd M., et al.
(författare)
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Effects of phase transformations on residual stresses in welding of stainless steels
- 2007
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Ingår i: International Journal of Offshore and Polar Engineering. - 1053-5381. ; 17:2, s. 145-151
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Tidskriftsartikel (refereegranskat)abstract
- In this investigation, we investigate the effects of solid state phase transformation on residual stresses in welding super-martensitic stainless steels, using the Satoh experimental test approach. The results obtained clearly demonstrate that the austenite-to-martensite phase transformation has remarkable effects on the final tensile residual stress level, and stresses as low as 70 to 170 MPa were found, depending on the weld thermal program. These results may imply that unnecessary conservatism is often used when assuming residual stresses to be of the same order as the base metal yield strength.
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| 6. |
- Akselsen, O. M., et al.
(författare)
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Root bead profiles in hyperbaric GTAW of X70 pipeline
- 2006
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Ingår i: International Journal of Offshore and Polar Engineering. - 1053-5381. ; 16:2, s. 123-127
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Tidskriftsartikel (refereegranskat)abstract
- This investigation began with the goal of studying the root bead penetration profiles in hyperbaric GTAW welding of X70 pipelines. Such profiles may vary substantially depending on the wire and base metal chemical composition. Root beads were deposited with a pressure corresponding to 75-m seawater depth, and with a systematic increase of 10 A in the pulse current until burnthrough took place. The results obtained showed that the penetration profiles were different between the 2 wires included in the welding program. The largest penetration width was found for wire B with the highest sulphur content (0.013% S), with a maximum width of about 8-mm width on the pipe inside for 160 A. At pulse current levels of 120 to 170 A, the difference between the 2 wires was about 1 mm. With current beyond 180 A, the profiles approached similar values, followed by burnthroughs for both wires at 190 A. However, the welding parameters were already too hot at 180 A. These results are probably caused by a Marangoni convection in the weld pool. A high content of surface active elements (e.g., sulphur) is known to shift the How pattern, providing deeper penetration. In practice, small variations in the bead penetration profile may have large consequences during offshore tie-in welding. Cost-increasing repair operations may be required if nondestructive inspection later reveals poor root bead quality. Such actions require mobilisation of huge resources.
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| 7. |
- Akselsen, Odd M., et al.
(författare)
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Weld metal mechanical properties in hyperbaric GTAW of X70 pipeline
- 2006
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Ingår i: International Journal of Offshore and Polar Engineering. - 1053-5381. ; 16:3, s. 233-240
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Tidskriftsartikel (refereegranskat)abstract
- In the present investigation, 2 different wires for hyperbaric (underwater) GTA (gas tungsten arc) welding of X70 pipelines have been tested with respect to their weld metal mechanical properties. Welding of full coupons at different pressures (seawater depths of 16, 75 and 200 msw) was done with subsequent weld metal chemical analyses, hardness measurements, tensile testing and Charpy V notch testing as well as microstructure characterization. It is shown that both wires satisfied strength requirements set to X70 grade, representing a weld metal overmatch situation. Both wires gave sufficient impact toughness, but the toughness of the Ni-Mo containing weld was reduced with increasing seawater depth. This observation was strongly linked to the positioning of the Charpy V notch, and crack growth in a brittle, partially transformed region as a consequence of reheating by subsequent stringer beads. The embrittling microstructure consisted of high carbon MA (martensite-austenite constituents islands) decorating prior austenite grain boundaries. This microstructure was less pronounced when welding with the high Ni wire, which may explain why no similar toughness drop was found.
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| 8. |
- Aune, Ragnhild E., et al.
(författare)
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Thermodynamic approach to physical properties of silicate melts
- 2005
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Ingår i: Ironmaking & steelmaking. - : Informa UK Limited. - 0301-9233 .- 1743-2812. ; 32:2, s. 141-150
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Tidskriftsartikel (refereegranskat)abstract
- The thermophysical properties of silicate melts are strongly structure dependent. It is well known that the viscosity of slags increases with increasing degree of polymerisation of the silicate anion. Even the thermodynamic properties of slags are dependent on the species type and population in the melt. Thus, a link between the thermophysical and thermochemical properties of silicate melts is logically expected. The present paper elucidates the salient features of Darken's excess stability approach to the Gibbs energy of solution as applied to the viscosities of silicate melts. It is demonstrated that the second derivatives of the viscosities of binary silicate melts with respect to composition indicate maxima corresponding to the existence of stable compounds in these systems. The concept has been successfully applied to the following systems: Al2O3-SiO2, CaO-SiO2, FeO-SiO2, MgO-SiO2 and MnO-SiO2. In all cases, the second derivative plots of viscosities with respect to composition show peaks corresponding to the metasilicates. The second derivatives of the activation energies of viscous flow with respect to temperature have earlier been shown to reflect the formation of associates/embryos in homogeneous silicate melts, indicating the readiness of the melt to separate a solid phase. Thermodynamic coupling of thermal diffusivities in the case of the CaO-Al2O3-SiO2 system from laser flash measurements of these slags, as a function of temperature, has been examined as part of the present study. Densities have been estimated from integral molar enthalpies in the case of silicate systems, and the results are presented.
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| 9. |
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| 10. |
- Darnerud, P O, et al.
(författare)
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Dietary intake estimations of organohalogen contaminants (dioxins, PCB, PBDE and chlorinated pesticides, e.g. DDT) based on Swedish market basket data
- 2006
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Ingår i: Food and Chemical Toxicology. - : Elsevier BV. - 0278-6915 .- 1873-6351. ; 44:9, s. 1597-1606
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Tidskriftsartikel (refereegranskat)abstract
- By use of a Swedish Market basket study from 1999, in which foods were sampled from four regions, the dietary intake of persistent organic pollutants (POPs) was assessed. Based on earlier data, six food groups (fish, meat, dairy products, egg, fats/oils, and pastries; comprising 52 food items) were selected for POP analyses. Homogenates from these six groups were subjected to POP analyses and levels presented on dioxins (PCDD/PCDFs), dioxin-like PCBs, PCB-153, summation operatorPCBs, BDE-47, summation operatorPBDEs, DDE, summation operatorDDTs, HCB, summation operatorHCHs, and summation operatorchlordanes, after adjusting non-quantified levels to 1/2 LOQ. For all compounds, the fish homogenate contained the comparatively highest levels, on a fresh weight basis. Intake calculations based on the six food groups showed that summation operatorPCBs and summation operatorDDTs gave per capita intakes of 615 and 523 ng/day, respectively, that the estimated summation operatorPBDE intake was 51 ng/day and that of dioxins and dioxin-like PCBs was 96 pg WHO-TEQ/day. The estimated mean intakes were below (total-TEQ: 1.3 pg/kgbw/day) or well below (summation operatorDDTs: 8.9 ng/kgbw/day) internationally agreed intake limits (total-TEQ: 2 pg/kgbw/day; summation operatorDDTs: 10,000 ng/kgbw/day). A number of uncertainty factors, including analytical limitations due to low POP levels in food, give reason for caution in the use of the presented intake data. However, the intake estimations of dioxins, summation operatorPCBs and summation operatorPBDEs are well in accordance to calculations of POP intakes in Sweden made by alternate methods.
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