| 1. |
- Aad, G., et al.
(författare)
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- 2010
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swepub:Mat__t
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| 2. |
- Aad, G., et al.
(författare)
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- 2010
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swepub:Mat__t
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| 3. |
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| 4. |
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| 5. |
- Kovacevic, A., et al.
(författare)
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Fetal aortic valvuloplasty : investigating institutional bias in surgical decision-making
- 2014
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Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 44:5, s. 538-544
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Fetal aortic valvuloplasty may prevent the progression of aortic stenosis to hypoplastic left heart syndrome and allow biventricular rather than univentricular postnatal treatment. This study aimed to investigate whether blinded simulation of a multidisciplinary team approach aids interpretation of multicenter data to uncover institutional bias in postnatal decision-making following fetal cardiac intervention for aortic stenosis. Methods The study included 109 cases of prenatally diagnosed aortic stenosis from 13 European countries, of which 32 had undergone fetal cardiac intervention. The multidisciplinary team, blinded to fetal cardiac intervention, institutional location and postnatal treatment, retrospectively assigned a surgical pathway (biventricular or univentricular) based on a review of recorded postnatal imaging and clinical characteristics. The team's decisions were the numerical consensus of silent voting, with case review when a decision was split. Funnel plots showing concordance between the multidisciplinary team and the local team's surgical choice (first pathway) and with outcome (final pathway) were created. Results In 105 cases the multidisciplinary team reached a consensus decision regarding the surgical pathway, with no decision in four cases because the available imaging records were inadequate. Blinded multidisciplinary team consensus for the first pathway matched the decision of the surgical center in 93/105 (89%) cases, with no difference in agreement between those that had undergone successful fetal cardiac intervention (n= 32) and no (n= 74) or unsuccessful (n= 3) valvuloplasty (no fetal cardiac intervention) (kappa = 0.73 (95% CI, 0.38-1.00) vs 0.74 (95% CI, 0.51-0.96)). However, funnel plots comparing multidisciplinary team individual decisions with those of the local teams displayed more discordance (meaning biventricular-univentricular conversion) for the final surgical pathway following fetal cardiac intervention than they did for cases without such intervention (36/74 vs 34/130; P = 0.002), and identified one outlying center. Conclusions The use of a blinded multidisciplinary team to simulate decision-making and presentation of data in funnel plots may assist in the interpretation of data submitted to multicenter studies and permit the identification of outliers for further investigation. In the case of aortic stenosis, a high level of agreement was observed between the multidisciplinary team and the surgical centers, but one outlying center was identified.
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| 6. |
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| 7. |
- Zhou, Helin, et al.
(författare)
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Close electric field changes associated with upward-initiated lightning at the Gaisberg Tower
- 2011
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Ingår i: 2011 International Symposium on Lightning Protection, XI SIPDA 2011. - 9781457718977 ; , s. 87-90
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- We examine in detail the simultaneous lightning current waveforms, close electric field changes, and lighting location system data for upward lightning discharges initiated from the Gaisberg Tower (GBT) from 2005 to 2009. Out of 205 upward flashes, we find that most of upward flashes (179/205 or 87%) are initiated at the tower top without any nearby preceding discharge activity, 26 flashes (13%) are initiated by nearby triggering lightning discharges, including 10 positive cloud-to-ground lightning, 1 negative cloud-to-ground lightning, and 15 cloud discharges. The possible reasons for self-triggered upward flashes dominating at the GBT would be the field enhancement due to the Gaisberg Mountain above 800 m of the surrounding terrain of the city of Salzburg and low cloud base during cold season.
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| 8. |
- Zhou, Helin, et al.
(författare)
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Mixed mode of charge transfer to ground for initial continuous current pulses in upward lightning
- 2011
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Ingår i: 2011 7th Asia-Pacific International Conference on Lightning (APL). ; , s. 677-681
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Konferensbidrag (refereegranskat)abstract
- In this paper, we discuss properties of initial continuous current (ICC) pulses superimposed on the slow varying initial stage current in upward flashes initiated from the Gaisberg Tower (GBT) based on simultaneous current, near/far electric field measurements. ICC pulses are usually associated with M-component mode of charge transfer to ground, if only one branch of the lightning channel is active. However, there are several cases in which ICC pulses involve a predominantly leader/return-stroke mode of charge transfer to ground in a new channel that connects to the old channel carrying continuous current. With the help of high-speed video camera records, we find that this mixed mode of charge transfer for ICC pulses, leader-return stroke in one channel and continuous current in another channel, occurring simultaneously during the initial stage current in upward lightning from tall towers is very common. This is in contrast to triggered-lightning where usually only one channel is dominant and ICC pulses are associated predominantly with M-component mode of charge transfer. Also, ICC pulses with mixed-mode of charge transfer have shorter risetimes, larger peaks, and shorter half-peak widths.
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| 9. |
- Zhou, H, et al.
(författare)
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The influence of meteorological conditions on upward lightning initiation at the Gaisberg Tower
- 2014
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Ingår i: 2014 International Conference on Lightning Protection, ICLP 2014. - 9781479935444 ; , s. 1162-1165
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Konferensbidrag (refereegranskat)abstract
- Meteorological parameters associated with the initiation of upward lightning discharges from a tall tower were investigated. The parameters, including temperature, wind speed, air pressure, and relative humidity, were measured at the Gaisberg Tower top and at a distance of 170 m from the tower. A comparison of parameters associated with self-initiated upward flashes (initiated without any nearby preceding lightning activity) and nearby-lightning-triggered upward flashes (triggered by nearby preceding lightning activity) was made. It shows that at the Gaisberg Tower (GBT), relatively low ambient temperature facilitates to initiate upward flashes without any nearby preceding lightning activity. Relatively high ambient temperature (8.5 °C to 15.5 °C) facilitates to initiate upward positive stepped leaders, rather than the common continuous leaders, in the self-initiated upward negative flashes. No reliable correlation between wind speed and upward initiation of lightning was found.
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