| 1. |
- Huijben, Jilske A., et al.
(författare)
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Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury
- 2019
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Ingår i: Critical Care. - : BioMed Central. - 1364-8535 .- 1466-609X. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to develop a set of quality indicators for patients with traumatic brain injury (TBI) in intensive care units (ICUs) across Europe and to explore barriers and facilitators for implementation of these quality indicators.Methods: A preliminary list of 66 quality indicators was developed, based on current guidelines, existing practice variation, and clinical expertise in TBI management at the ICU. Eight TBI experts of the Advisory Committee preselected the quality indicators during a first Delphi round. A larger Europe-wide expert panel was recruited for the next two Delphi rounds. Quality indicator definitions were evaluated on four criteria: validity (better performance on the indicator reflects better processes of care and leads to better patient outcome), feasibility (data are available or easy to obtain), discriminability (variability in clinical practice), and actionability (professionals can act based on the indicator). Experts scored indicators on a 5-point Likert scale delivered by an electronic survey tool.Results. The expert panel consisted of 50 experts from 18 countries across Europe, mostly intensivists (N=24, 48%) and neurosurgeons (N=7, 14%). Experts agreed on a final set of 42 indicators to assess quality of ICU care: 17 structure indicators, 16 process indicators, and 9 outcome indicators. Experts are motivated to implement this finally proposed set (N=49, 98%) and indicated routine measurement in registries (N=41, 82%), benchmarking (N=42, 84%), and quality improvement programs (N=41, 82%) as future steps. Administrative burden was indicated as the most important barrier for implementation of the indicator set (N=48, 98%).Conclusions: This Delphi consensus study gives insight in which quality indicators have the potential to improve quality of TBI care at European ICUs. The proposed quality indicator set is recommended to be used across Europe for registry purposes to gain insight in current ICU practices and outcomes of patients with TBI. This indicator set may become an important tool to support benchmarking and quality improvement programs for patients with TBI in the future.
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| 2. |
- Roelfsema, P. R., et al.
(författare)
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SPICA-A Large Cryogenic Infrared Space Telescope : Unveiling the Obscured Universe
- 2018
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Ingår i: Publications Astronomical Society of Australia. - : Cambridge University Press (CUP). - 1323-3580 .- 1448-6083. ; 35
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Tidskriftsartikel (refereegranskat)abstract
- Measurements in the infrared wavelength domain allow direct assessment of the physical state and energy balance of cool matter in space, enabling the detailed study of the processes that govern the formation and evolution of stars and planetary systems in galaxies over cosmic time. Previous infrared missions revealed a great deal about the obscured Universe, but were hampered by limited sensitivity. SPICA takes the next step in infrared observational capability by combining a large 2.5-meter diameter telescope. cooled to below 8 K, with instruments employing ultra-sensitive detectors. A combination of passive cooling and mechanical coolers will be used to cool both the telescope and the instruments. With mechanical coolers the mission lifetime is not limited by the supply of cryogen. With the combination of low telescope background and instruments with state-of-the-art detectors SPICA provides a huge advance on the capabilities of previous missions. SPICA instruments offer spectral resolving power ranging from R similar to 50 through 11 000 in the 17-230 mu m domain and R similar to 28.000 spectroscopy between 12 and 18 mu m.SPICA will provide efficient 30-37 mu m broad band mapping, and small field spectroscopic and polarimetric imaging at 100, 200 and 350 mu m. SPICA will provide infrared spectroscopy with an unprecedented sensitivity of similar to 5 x 10(-20) W m (-2) (5 sigma/1 h)-over two orders of magnitude improvement over what earlier missions. This exceptional performance leap, will open entirely new domains in infrared astronomy; galaxy evolution and metal production over cosmic time, dust formation and evolution from very early epochs onwards, the formation history of planetary systems.
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| 3. |
- Walker, Steven M, et al.
(författare)
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Molecular Subgroup of Primary Prostate Cancer Presenting with Metastatic Biology
- 2017
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838 .- 1873-7560. ; 72:4, s. 509-518
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Approximately 4-25% of patients with early prostate cancer develop disease recurrence following radical prostatectomy.OBJECTIVE: To identify a molecular subgroup of prostate cancers with metastatic potential at presentation resulting in a high risk of recurrence following radical prostatectomy.DESIGN, SETTING, AND PARTICIPANTS: Unsupervised hierarchical clustering was performed using gene expression data from 70 primary resections, 31 metastatic lymph nodes, and 25 normal prostate samples. Independent assay validation was performed using 322 radical prostatectomy samples from four sites with a mean follow-up of 50.3 months.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Molecular subgroups were identified using unsupervised hierarchical clustering. A partial least squares approach was used to generate a gene expression assay. Relationships with outcome (time to biochemical and metastatic recurrence) were analysed using multivariable Cox regression and log-rank analysis.RESULTS AND LIMITATIONS: A molecular subgroup of primary prostate cancer with biology similar to metastatic disease was identified. A 70-transcript signature (metastatic assay) was developed and independently validated in the radical prostatectomy samples. Metastatic assay positive patients had increased risk of biochemical recurrence (multivariable hazard ratio [HR] 1.62 [1.13-2.33]; p=0.0092) and metastatic recurrence (multivariable HR=3.20 [1.76-5.80]; p=0.0001). A combined model with Cancer of the Prostate Risk Assessment post surgical (CAPRA-S) identified patients at an increased risk of biochemical and metastatic recurrence superior to either model alone (HR=2.67 [1.90-3.75]; p<0.0001 and HR=7.53 [4.13-13.73]; p<0.0001, respectively). The retrospective nature of the study is acknowledged as a potential limitation.CONCLUSIONS: The metastatic assay may identify a molecular subgroup of primary prostate cancers with metastatic potential.PATIENT SUMMARY: The metastatic assay may improve the ability to detect patients at risk of metastatic recurrence following radical prostatectomy. The impact of adjuvant therapies should be assessed in this higher-risk population.
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| 4. |
- Wiedner, M.C., et al.
(författare)
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A Proposed Heterodyne Receiver for the Origins Space Telescope
- 2018
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Ingår i: IEEE Transactions on Terahertz Science and Technology. - 2156-342X .- 2156-3446. ; 8:6, s. 558-571
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Tidskriftsartikel (refereegranskat)abstract
- The HEterodyne Receiver for the Origins Space Telescope (HERO) is a proposed design for a heterodyne focal plane array for a large space mission. The Origins Space Telescope (OST) is one of the four missions selected to be studied by NASA for the 2020 Astronomy and Astrophysics Decadal survey. HERO is designed to observe the trail of water from the interstellar medium (ISM) to disks around protostars. In Concept 1, HERO provides continuous frequency coverage from 468 to 2700 GHz in five bands and a sixth band to cover 4700 GHz. Most bands include 2 × 64 pixels providing at least an order of magnitude higher mapping speeds than available with today's instruments. Receiver sensitivities are expected to be close to the quantum limit. HERO Concept 2, highly constrained by cost and denoted Little-HERO, includes four bands with continuous coverage from 486 to 2700 GHz and with focal plane arrays having only 2 × 9 pixels per band. Both of these THz receiver concepts will be described and the designs will be motivated by the science drivers, the space craft constraints and the latest technological developments. The HERO design builds on the highly successful Herschel/Heterodyne Instrument for the Far-Infrared, on Stratospheric Observatory for Far-Infrared Astronomy/upGREAT and many other heterodyne receivers, but surpasses these in terms of frequency coverage, array size and sensitivity, thanks to the latest technical advances. HERO can be considered an example of a new generation of heterodyne focal plane arrays for future space missions.
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| 5. |
- Wiedner, M.C., et al.
(författare)
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Heterodyn receiver for the Origins Space Telescope concept 2
- 2018
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Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 10698
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Konferensbidrag (refereegranskat)abstract
- The Origins Space Telescope (OST) is a NASA study for a large satellite mission to be submitted to the 2020 Decadal Review. The proposed satellite has a fleet of instruments including the HEterodyne Receivers for OST (HERO). HERO is designed around the quest to follow the trail of water from the ISM to disks around protostars and planets. HERO will perform high-spectral resolution measurements with 2x9 pixel focal plane arrays at any frequency between 468GHz to 2,700GHz (617 to 111 μm). HERO builds on the successful Herschel/HIFI heritage, as well as recent technological innovations, allowing it to surpass any prior heterodyne instrument in terms of sensitivity and spectral coverage.
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| 6. |
- Wiedner, M.C., et al.
(författare)
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The origins space telescope and the heterodyne receiver for origins (HERO)
- 2019
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Ingår i: ISSTT 2019 - 30th International Symposium on Space Terahertz Technology, Proceedings Book. ; , s. 204-207
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Konferensbidrag (refereegranskat)abstract
- The Origins Space Telescope is one of four large mission concept studies carried out by NASA for the 2020 Decadal survey. Origins is a far-infrared telescope designed to understand the evolution of galaxies and black holes, to follow the trail of water from protostars to habitable planets and to search for biosignatures in the atmospheres of exoplanets. The Heterodyne Receiver for Origins (HERO) is the high spectral resolution receiver. It is the first heterodyne array receiver designed to fly on a satellite and an example for possible future focal plane arrays for space. HERO has focal plane arrays with nine pixels in two polarization. HERO covers a large frequency range between 486 and 2700 GHz in only 4 frequency bands, requiring local oscillators with fractional bandwidth of 45%. HERO uses the best superconducting mixers with noise temperatures between 1 and 3 hf/k and an intermediate bandwidth of 6 to 8 GHz. HERO can carry out dual polarization and dual-frequency observations. The major challenges for the HERO design are the low cooling power and the low electrical power available on a spacecraft, which impact the choice of the cryogenic amplifiers and backends. SiGe cryogenic amplifiers with a consumption of less than 0.5 mW, as well as CMOS spectrometers with a power consumption below 2W are the baseline for HERO. The development plan includes broadband (45%) multiplier-amplifier chains, low noise mixers (1-3 hf/k), low-power consuming (< 05.mW) cryogenic amplifiers and low-power consuming spectrometer backends (< 2W).
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