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- Drake, Thomas M., et al.
(författare)
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Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction
- 2019
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Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 45:12, s. 2319-2324
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology Introduction: Patients with cancer who develop small bowel obstruction are at high risk of malnutrition and morbidity following compromise of gastrointestinal tract continuity. This study aimed to characterise current management and outcomes following malignant small bowel obstruction. Methods: A prospective, multicentre cohort study of patients with small bowel obstruction who presented to UK hospitals between 16th January and 13th March 2017. Patients who presented with small bowel obstruction due to primary tumours of the intestine (excluding left-sided colonic tumours) or disseminated intra-abdominal malignancy were included. Outcomes included 30-day mortality and in-hospital complications. Cox-proportional hazards models were used to generate adjusted effects estimates, which are presented as hazard ratios (HR) alongside the corresponding 95% confidence interval (95% CI). The threshold for statistical significance was set at the level of P ≤ 0.05 a-priori. Results: 205 patients with malignant small bowel obstruction presented to emergency surgery services during the study period. Of these patients, 50 had obstruction due to right sided colon cancer, 143 due to disseminated intraabdominal malignancy, 10 had primary tumours of the small bowel and 2 patients had gastrointestinal stromal tumours. In total 100 out of 205 patients underwent a surgical intervention for obstruction. 30-day in-hospital mortality rate was 11.3% for those with primary tumours and 19.6% for those with disseminated malignancy. Severe risk of malnutrition was an independent predictor for poor mortality in this cohort (adjusted HR 16.18, 95% CI 1.86 to 140.84, p = 0.012). Patients with right-sided colon cancer had high rates of morbidity. Conclusions: Mortality rates were high in patients with disseminated malignancy and in those with right sided colon cancer. Further research should identify optimal management strategy to reduce morbidity for these patient groups.
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- Aflaki, Inga Narbutaite, et al.
(författare)
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Entrepreneurship in the polis : Understanding political entrepreneurship
- 2015. - 1
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Dynamics of entrepreneurship have attracted growing attention from scholars of political science, policy studies, public administration and planning, as well as more recently, from the realms of international relations and foreign policy analysis. Under the banner of political entrepreneurship, this volume considers and maps out conceptual approaches to the study of entrepreneurship drawn from these fields, discusses synergies, envisages new analytical tools and offers contemporary empirical case studies, illustrating the diverse political contexts in which entrepreneurship takes place in the polis. Drawing upon an international cast of senior academics and cutting edge young researchers, the volume takes a closer look at key aspects of political entrepreneurship, such as, defining political entrepreneurs, how it relates to change, decision-making and strategies, organizational arrangements, institutional rules, varying contexts and future research agendas. By highlighting the political aspects of entrepreneurship, the volume presents new exciting opportunities for understanding entrepreneurial activities at regional, national and international levels. The volume will be of particular relevance to scholars and students of political science, policy studies, public administration, planning, international relations and business studies as well as practitioners interested in the nexus and utility of entrepreneurship in the modern-day political world.
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- Agarwal, Girish, et al.
(författare)
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Light, the universe and everything-12 Herculean tasks for quantum cowboys and black diamond skiers
- 2018
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Ingår i: Journal of Modern Optics. - : Informa UK Limited. - 0950-0340 .- 1362-3044. ; 65:11, s. 1261-1308
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Tidskriftsartikel (refereegranskat)abstract
- The Winter Colloquium on the Physics of Quantum Electronics (PQE) has been a seminal force in quantum optics and related areas since 1971. It is rather mind-boggling to recognize how the concepts presented at these conferences have transformed scientific understanding and human society. In January 2017, the participants of PQE were asked to consider the equally important prospects for the future, and to formulate a set of questions representing some of the greatest aspirations in this broad field. The result is this multi-authored paper, in which many of the world's leading experts address the following fundamental questions: (1) What is the future of gravitational wave astronomy? (2) Are there new quantum phases of matter away from equilibrium that can be found and exploited - such as the time crystal? (3) Quantum theory in uncharted territory: What can we learn? (4) What are the ultimate limits for laser photon energies? (5) What are the ultimate limits to temporal, spatial and optical resolution? (6) What novel roles will atoms play in technology? (7) What applications lie ahead for nitrogen-vacancy centres in diamond? (8) What is the future of quantum coherence, squeezing and entanglement for enhanced super-resolution and sensing? (9) How can we solve (some of) humanity's biggest problems through new quantum technologies? (10) What new understanding of materials and biological molecules will result from their dynamical characterization with free-electron lasers? (11) What new technologies and fundamental discoveries might quantum optics achieve by the end of this century? (12) What novel topological structures can be created and employed in quantum optics?
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- Cleynen, Isabelle, et al.
(författare)
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Inherited determinants of Crohn's disease and ulcerative colitis phenotypes : a genetic association study
- 2016
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Ingår i: The Lancet. - New York, USA : Elsevier. - 0140-6736 .- 1474-547X. ; 387:10014, s. 156-167
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Tidskriftsartikel (refereegranskat)abstract
- Background: Crohn's disease and ulcerative colitis are the two major forms of inflammatory bowel disease; treatment strategies have historically been determined by this binary categorisation. Genetic studies have identified 163 susceptibility loci for inflammatory bowel disease, mostly shared between Crohn's disease and ulcerative colitis. We undertook the largest genotype association study, to date, in widely used clinical subphenotypes of inflammatory bowel disease with the goal of further understanding the biological relations between diseases.Methods This study included patients from 49 centres in 16 countries in Europe, North America, and Australasia. We applied the Montreal classification system of inflammatory bowel disease subphenotypes to 34,819 patients (19,713 with Crohn's disease, 14,683 with ulcerative colitis) genotyped on the Immunochip array. We tested for genotype-phenotype associations across 156,154 genetic variants. We generated genetic risk scores by combining information from all known inflammatory bowel disease associations to summarise the total load of genetic risk for a particular phenotype. We used these risk scores to test the hypothesis that colonic Crohn's disease, ileal Crohn's disease, and ulcerative colitis are all genetically distinct from each other, and to attempt to identify patients with a mismatch between clinical diagnosis and genetic risk profile.Findings: After quality control, the primary analysis included 29,838 patients (16,902 with Crohn's disease, 12,597 with ulcerative colitis). Three loci (NOD2, MHC, and MST1 3p21) were associated with subphenotypes of inflammatory bowel disease, mainly disease location (essentially fixed over time; median follow-up of 10·5 years). Little or no genetic association with disease behaviour (which changed dramatically over time) remained after conditioning on disease location and age at onset. The genetic risk score representing all known risk alleles for inflammatory bowel disease showed strong association with disease subphenotype (p=1·65 × 10(-78)), even after exclusion of NOD2, MHC, and 3p21 (p=9·23 × 10(-18)). Predictive models based on the genetic risk score strongly distinguished colonic from ileal Crohn's disease. Our genetic risk score could also identify a small number of patients with discrepant genetic risk profiles who were significantly more likely to have a revised diagnosis after follow-up (p=6·8 × 10(-4)).Interpretation: Our data support a continuum of disorders within inflammatory bowel disease, much better explained by three groups (ileal Crohn's disease, colonic Crohn's disease, and ulcerative colitis) than by Crohn's disease and ulcerative colitis as currently defined. Disease location is an intrinsic aspect of a patient's disease, in part genetically determined, and the major driver to changes in disease behaviour over time.Funding: International Inflammatory Bowel Disease Genetics Consortium members funding sources (see Acknowledgments for full list).
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- Lindh, Magnus, 1960-
(författare)
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Regionen och EU? : Uppfattningar och attityder till EU-relaterade frågor i Västsverige
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explores perceptions and preferences on regional action in EU-related frameworks among regional actors in Western Sweden. Building upon the literature on Europeanisation and the Fusion approach, three dimensions of Europeanisation are clarified and explored– download, upload and crossload – and together with a set of five variables that constitute the Micro Fusion Framework; a comprehensive analytical tool is developed. The thesis analyses the intense debate among the members of West Sweden that took place from 2011 to 2013 that focused on how to functionally organise the regional office in Brussels in order to meet future challenges. Surprisingly, the members eventually decided to terminate their cooperation and close the jointly owned office in Brussels in spite of the fact that it has been widely regarded as successful and effective. Diverging perceptions and preferences is understood in terms of three positions on regional action; a download-, upload- and a coherent oriented position. Finally, the thesis presents the empirical findings and discusses in relation to three fusion scenarios, infusion, defusion and clustered fusion.In terms of Micro Fusion Framework, the dynamics shaping why West Sweden was finally regarded as a dysfunctional arena for regional action are explained by a shift of attention and action among regional actors in Western Sweden that led to pressure for further institutional adaptation in order to meet the demand of how ‘to get the best out of the EU’. Further, this redefinition of how to handle EU-affairs within the upload-oriented position was accompanied by positive attitudes towards the potential to bypass the state and thereby pursue regional priorities directly in Brussels given the compound nature of the EU. In contrast, those regional actors that are found to be more download-oriented often question the benefits of uploading activities in practice and advocate close relations to the state. A coherent oriented position recognises the importance of activities related to both of the vertical dimensions of Europeanisation.
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