| 11. |
- Huybrighs, H. L. F., et al.
(författare)
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Reply to Comment on "An Active Plume Eruption on Europa During Galileo Flyby E26 as Indicated by Energetic Proton Depletions"
- 2021
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Ingår i: Geophysical Research Letters. - : American Geophysical Union (AGU). - 0094-8276 .- 1944-8007. ; 48:18
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Tidskriftsartikel (refereegranskat)abstract
- In Huybrighs et al. (2020, https://doi.org/10.1029/2020gl087806) we investigated energetic proton depletions along Galileo's Europa flyby E26. Based on a particle tracing analysis, we proposed that depletions are caused by perturbed electromagnetic fields combined with atmospheric charge exchange and possible plumes. One depletion feature identified as a plume signature was shown to be an artifact (Jia et al., 2021, https://doi.org/10.1029/2020gl091550). Despite that, here we emphasize that Huybrighs et al. (2020, https://doi.org/10.1029/2020gl087806) demonstrates that plumes can cause proton depletions and that these features should be sought after. Furthermore, the conclusions on the importance of perturbed electromagnetic fields and atmospheric charge exchange on the depletions are unaffected. We suggest that the artifact's cause is a mistagging of protons as heavier ions by EPD. The artifact prevents us from confirming or excluding that there is a plume-associated depletion. We also address comments on the MHD simulations and demonstrate that 540-1,040 keV losses are not necessarily inconsistent with 115-244 keV losses by plume-associated charge exchange. Plain Language Summary In Huybrighs et al. (2020, https://doi.org/10.1029/2020gl087806) we identified why fast protons were disappearing during Europa flyby E26 by Galileo. Beyond impacting on the surface, we identified several contributing factors: First, perturbed electromagnetic fields resulting from the interaction of Europa's atmosphere with the magnetospheric plasma, which deflect the protons. Second, atmospheric charge exchange. We also showed that a water plume eruption could cause a region in which disappearances occur due to a combination of charge exchange and magnetic deflections. We identified a 20s decrease of protons as evidence of such a plume. However, an artifact in the data reported by Jia et al. (2021, https://doi.org/10.1029/2020gl091550) coincides with this 20s moment and prevents us from reaching a conclusion on the occurrence of a plume-associated depletion. We emphasize that our conclusions on the importance of perturbed fields and charge exchange are unaffected, as the artifact only affects a short segment of the data we analyzed. Furthermore, our results demonstrate that plumes can cause proton depletions and that these features should be sought after in the data.
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| 12. |
- Osborne, M. S., et al.
(författare)
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Clinical Evaluation of a Novel Laser-Ablated Titanium Implant System for Bone Anchored Hearing Systems in a Pediatric Population and the Relationship of Resonance Frequency Analysis With Implant Survival
- 2022
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Ingår i: Otology & Neurotology. - : Ovid Technologies (Wolters Kluwer Health). - 1531-7129 .- 1537-4505. ; 43:2, s. 219-226
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the clinical outcomes of pediatric patients implanted a novel 4.5 mm wide laser ablated titanium bone anchored implant system and to evaluate the implant stability over the first 12-month period. Study Design: A prospective, single-subject, repeated measure, cohort study. Participants served as their own controls. Setting: Community and tertiary referral hospital pediatric assessment center. Patients: A total of 115 consecutive pediatric patients aged 4 to 15 years were implanted with 176 laser ablated titanium bone anchored implants from January 2016 to January 2019. Main Outcome Measure: Clinical outcomes, implant failure rates, and post implantation implant stability quotient (ISQ) scores were studied over the first 12-month period. Data were analyzed for statistical significance through mixed effect modeling, with the significance level p = 0.01. Results: A median 12-month survival of 96.6% was observed. Six implants (3.5%) were lost in total, one of these (0.6%) was lost due to trauma. Adverse skin reactions (Holgers grade 2-4) were observed in 4.4% of all postoperative visits, occurring in 22 individuals (19.1%). Neither the ISQ high (ISQH) nor ISQ low (ISQL) values increased significantly between the stage 1 and 2 surgeries. In contrast, the ISQ results, irrespective of abutment size, demonstrated an increasing trend from 49.1 to 57 over the 12 months review period. A statistically significant change was only demonstrated from the 3 months follow up onwards. Conclusion: The use of 4.5 mm wide laser-ablated titanium bone anchored hearing implants resulted in superior survival rates and excellent clinical outcomes compared with previous implant systems.
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| 13. |
- Strijbos, R. M., et al.
(författare)
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Health Economic Cost Analysis for Percutaneous Bone Conduction Devices: The Minimally Invasive Ponto Surgery Versus Linear Incision Technique with Tissue Preservation
- 2023
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Ingår i: Otology & Neurotology. - 1531-7129. ; 44:7, s. 709-717
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo identify differences in mean cost per patient between the Minimally Invasive Ponto Surgery (MIPS) and the linear incision technique with tissue preservation (LITT-P).Study designHealth economic cost analysis.SettingThe analysis was performed in a randomized multicenter controlled trial cohort.PatientsAdult patients eligible for unilateral bone conduction device surgery.InterventionsMIPS versus LITT-P surgery for bone conduction device implantation.Main outcome measuresPerioperative and postoperative costs were identified and compared.ResultsThe difference in mean cost per patient between both techniques was euro77.83 in favor of the MIPS after 22 months follow-up. The mean costs per patient were lower in the MIPS cohort for surgery (euro145.68), outpatient visits (euro24.27), systemic antibiotic therapy with amoxicillin/clavulanic acid (euro0.30) or clindamycin (euro0.40), abutment change (euro0.36), and abutment removal (euro0.18). The mean costs per patient were higher for implant and abutment set (euro18.00), topical treatment with hydrocortison/oxytetracycline/polymyxine B (euro0.43), systemic therapy with azithromycin (euro0.09) or erythromycin (euro1.15), local revision surgery (euro1.45), elective explantation (euro1.82), and implant extrusion (euro70.42). Additional analysis of scenarios in which all patients were operated under general or local anesthesia or with recalculation when using current implant survival rates showed that differences in mean cost per patient were also in favor of the MIPS.ConclusionThe difference between the MIPS and the LITT-P in mean cost per patient was euro77.83 in favor of the MIPS after 22 months of follow-up. The MIPS is an economically responsible technique and could be promising for the future.
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| 14. |
- Wennstig, Anna-Karin, 1973-, et al.
(författare)
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Risk of coronary stenosis after adjuvant radiotherapy for breast cancer
- 2022
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Ingår i: Strahlentherapie und Onkologie (Print). - : Springer Berlin/Heidelberg. - 0179-7158 .- 1439-099X. ; 198, s. 630-638
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Adjuvant radiotherapy (RT) for breast cancer is associated with an increased risk of ischemic heart disease. We examined the risk of coronary artery stenosis in a large cohort of women with breast cancer receiving adjuvant RT.Methods: A cohort of women diagnosed with breast cancer between 1992 and 2012 in three Swedish health care regions (n = 57,066) were linked to the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) to identify women receiving RT who subsequently underwent a percutaneous coronary intervention (PCI) due to coronary stenosis. Cox regression analyses were performed to examine risk of a coronary intervention and competing risk analyses were performed to calculate cumulative incidence.Results: A total of 649 women with left-sided breast cancer and 494 women with right-sided breast cancer underwent a PCI. Women who received left-sided RT had a significantly higher risk of a PCI in the left anterior descending artery (LAD) compared to women who received right-sided RT, hazard ratio (HR) 1.44 (95% confidence interval [CI] 1.21–1.77, p < 0.001). For the proximal, mid, and distal LAD, the HRs were 1.60 (95% CI 1.22–2.10), 1.38 (95% CI 1.07–1.78), and 2.43 (95% CI 1.33–4.41), respectively. The cumulative incidence of coronary events at 25 years from breast cancer diagnosis were 7.0% in women receiving left-sided RT and 4.4% in women receiving right-sided RT.Conclusion: Implementing and further developing techniques that lower cardiac doses is important in order to reduce the risk of long-term side effects of adjuvant RT for breast cancer.
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| 15. |
- Ahlberg, M., et al.
(författare)
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Time without PSA recurrence after radical prostatectomy as a predictor of prostate cancer death
- 2022
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Ingår i: European Urology. - : Elsevier. - 0302-2838 .- 1873-7560. ; 81:Suppl. 1, s. S286-S286
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction & Objectives: Although surveillance after radical prostatectomy routinely includes repeated Prostate Specific Antigen (PSA)-testing for many years, biochemical recurrence often occurs without further clinical progression. We therefore hypothesised that follow-up can be shortened for many patients without increasing the risk for prostate cancer death. We investigated the long-term probabilities of PSA recurrence, metastases and prostate cancer death in patients without biochemical recurrence 5 and 10 years after radical prostatectomy.Materials & Methods: Between 1989 and 1998, 14 urological centres in Scandinavia randomized patients to the Scandinavian Prostate Cancer Group study number 4 (SPCG-4) trial. Data was collected prospectively. All 306 patients from the SPCG-4 trial who underwent radical prostatectomy within 1 year from inclusion were eligible in our cohort. 4 patients were excluded due to surgery-related death (n=1) or salvage radiotherapy or hormonal treatment within 6 weeks from surgery (n=3). We stratified by Gleason score (≤3+4=7 or ≥4+3=7), pathological tumour stage (pT2 or ≥pT3), and negative or positive surgical margins. We analysed the cumulative incidences and absolute differences in metastatic disease and prostate cancer death.Results: We analysed 302 patients with complete follow-up during a median of 18 years. Median preoperative PSA was 9.8 ng/ml and median age at inclusion was 65 years. For patients without biochemical recurrence 5 years after radical prostatectomy the 20-year probability of biochemical recurrence was 25% among men with Gleason score ≤3+4=7 and 57% among men with Gleason score ≥4+3=7; the probabilities for metastases were 0.8% and 17%; and for prostate cancer death 0.8% and 12% respectively. The long-term probabilities were higher for pT≥3 vs. pT2 and for positive vs. negative surgical margins.Conclusions: Following radical prostatectomy, patients with Gleason score ≤3+4=7 without biochemical recurrence 5 years after radical prostatectomy had low risk of metastases and prostate cancer death independent of pT-stage and surgical margins. The risk of clinical progression decreased drastically the first 3 years after radical prostatectomy and after 10 years without biochemical recurrence, no patient was diagnosed with metastases or died from prostate cancer. Our study indicates that men with favourable histopathology without biochemical recurrence 5 years after radical prostatectomy can stop follow-up earlier than 10 years after radical prostatectomy while men with adverse pathology should continue with at least 10 years follow-up
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| 16. |
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| 17. |
- Appelbom, S, et al.
(författare)
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The Rapid Implementation of a Psychological Support Model for Frontline Healthcare Workers During the COVID-19 Pandemic: A Case Study and Process Evaluation
- 2021
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Ingår i: Frontiers in psychiatry. - : Frontiers Media SA. - 1664-0640. ; 12, s. 713251-
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic highlighted the need for psychological support initiatives directed toward frontline healthcare workers, which can be rapidly and sustainably implemented during an infectious disease outbreak. The current case study presents a comprehensive model of psychological support that was implemented at an intensive care unit (ICU) during the first wave of the COVID-19 pandemic. The psychological support model aimed at promoting a resilient stress reaction among frontline staff by protecting physical, social, and psychological resources. The initiatives, targeting different groups of workers, included education and training, peer support, psychologist-supervised and unsupervised group sessions, on-boarding for transferred staff, manager support, and individual sessions for workers experiencing strong stress reactions. The results of the process evaluation of this rapid implementation suggest that peer support initiatives as well as daily group sessions were the most appreciated forms of psychological support. Psychologists involved in organizing and providing the support highlighted several aspects of a successful implementation of the support model: offering support during work hours (preferably after shift), positive attitude of line managers that framed support initiatives as a team effort, and involvement of experienced psychologists able to quickly adjust the content of the support according to the current needs. The study also identified two main problems of the current implementation: the lack of efficient planning due to the use of volunteer work and the need for more structural resources on the organizational level to ensure long-term sustainability of the support model and its implementation among all groups of healthcare staff. The current case study highlights the importance of establishing permanent structural resources and routines for psychological support integrated in clinical practice by healthcare organizations to improve both rapid and sustainable response to future crises.
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| 18. |
- Axelsson, Lars, et al.
(författare)
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Swedish National Multicenter Study on Head and Neck Cancer of Unknown Primary: Prognostic Factors and Impact of Treatment on Survival
- 2021
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Ingår i: International Archives of Otorhinolaryngology. - : Georg Thieme Verlag KG. - 1809-9777 .- 1809-4864. ; 25:3
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established. Objective The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation. Methods A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients' medical records from 2008 to 2012. Results Two-hundred and sixty HNCUP patients were included. The tumors were HPVpositive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age (p < 0.001), performance status (p = 0.036), and N stage (p = 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups. Conclusions Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and ( chemo) radiation and primary (chemo)
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| 19. |
- Düking, Peter, et al.
(författare)
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Monitoring and adapting endurance training on the basis of heart rate variability monitored by wearable technologies : A systematic review with meta-analysis
- 2021
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Ingår i: Journal of Science and Medicine in Sport. - : Elsevier. - 1440-2440 .- 1878-1861. ; 24:11, s. 1180-1192
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Forskningsöversikt (refereegranskat)abstract
- Objectives: To systematically perform a meta-analysis of the scientific literature to determine whether the outcomes of endurance training based on heart rate variability (HRV) are more favorable than those of predefined training.Design: Systematic review and meta-analysis.Methods: PubMed and Web of Science were searched systematically in March of 2020 using keywords related to endurance, the ANS, and training. To compare the outcomes of HRV-guided and predefined training, Hedges' g effect size and associated 95% confidence intervals were calculated.Results: A total of 8 studies (198 participants) were identified comprising 9 interventions involving a variety of approaches. Compared to predefined training, most HRV-guided interventions included fewer moderate- and/or high-intensity training sessions. Fixed effects meta-analysis revealed a significant medium-sized positive effect of HRV-guided training on submaximal physiological parameters (g = 0.296, 95% CI 0.031 to 0.562, p = 0.028), but its effects on performance (g = 0.079, 95% CI −0.050 to 0.393, p = 0.597) and V̇O2peak (g = 0.171, 95% CI −0.213 to 0.371, p = 0.130) were small and not statistically significant. Moreover, with regards to performance, HRV-guided training was associated with fewer non-responders and more positive responders.Conclusions: In comparison to predefined training, HRV-guided endurance training had a medium-sized effect on submaximal physiological parameters, but only a small and non-significant influence on performance and V̇O2peak. There were fewer non-responders regarding performance with HRV-based training.
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| 20. |
- Düking, Peter, et al.
(författare)
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Predefined vs data-guided training prescription based on autonomic nervous system variation : A systematic review
- 2020
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 30:12, s. 2291-2304
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Tidskriftsartikel (refereegranskat)abstract
- Monitoring variations in the functioning of the autonomic nervous system may help personalize training of runners and provide more pronounced physiological adaptations and performance improvements. We systematically reviewed the scientific literature comparing physiological adaptations and/or improvements in performance following training based on responses of the autonomic nervous system (ie, changes in heart rate variability) and predefined training. PubMed, SPORTDiscus, and Web of Science were searched systematically in July 2019. Keywords related to endurance, running, autonomic nervous system, and training. Studies were included if they (a) involved interventions consisting predominantly of running training; (b) lasted at least 3 weeks; (c) reported pre- and post-intervention assessment of running performance and/or physiological parameters; (d) included an experimental group performing training adjusted continuously on the basis of alterations in HRV and a control group; and (e) involved healthy runners. Five studies involving six interventions and 166 participants fulfilled our inclusion criteria. Four HRV-based interventions reduced the amount of moderate- and/or high-intensity training significantly. In five interventions, improvements in performance parameters (3000 m, 5000 m, Loadmax, Tlim) were more pronounced following HRV-based training. Peak oxygen uptake ((Formula presented.)) and submaximal running parameters (eg, LT1, LT2) improved following both HRV-based and predefined training, with no clear difference in the extent of improvement in (Formula presented.). Submaximal running parameters tended to improve more following HRV-based training. Research findings to date have been limited and inconsistent. Both HRV-based and predefined training improve running performance and certain submaximal physiological adaptations, with effects of the former training tending to be greater.
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