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- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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- Beukes, Eldre W., et al.
(författare)
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Readability Following Cultural and Linguistic Adaptations of an Internet-Based Intervention for Tinnitus for Use in the United States
- 2020
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Ingår i: American Journal of Audiology. - Rockville, MD, United States : AMER SPEECH-LANGUAGE-HEARING ASSOC. - 1059-0889 .- 1558-9137. ; 29:2, s. 97-109
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitusrelated services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this study was to improve the cultural and linguistic suitability, and lower the readability level, of an existing program for tinnitus to ensure its suitability for U.S. English- and Spanish-speaking populations. Method: Guidelines for adaptation were followed and involved four phases: (a) cultural adaptations, as interventions targeted at specific cultures have been shown to improve outcomes; (b) creating Spanish materials to improve access of the materials to the large Spanish-speaking population in the United States; (c) professional review of the materials for acceptability as an intervention tool for a U.S. population; and (d) literacy-level adjustments to make the content accessible to those with lower levels of health literacy skills. Results: Cultural adaptations were made by using word substitutions, changing examples, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured suitability of the chapters. Literacy-level adjustments ensured all chapters were within the guidelines for readability grade levels below the sixth-grade level. Conclusions: The previously developed tinnitus materials were revised to adhere to best practice guidelines and ensure cultural suitability for adults with tinnitus in the United States. As it is also available in Spanish, members of the large Hispanic community also have access to the intervention in their first language. Further studies should determine whether these changes improve patients self-efficacy, engagement, and motivation to complete the intervention.
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- Bousquet, J, et al.
(författare)
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Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies
- 2020
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Ingår i: Clinical and translational allergy. - : Wiley. - 2045-7022. ; 10:1, s. 58-
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Tidskriftsartikel (refereegranskat)abstract
- There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.
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- Sahlberg, Arne
(författare)
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Multi-sightline neutron emission spectroscopy of D and T fusion plasmas at JET
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- An analysis of the neutron emission from a fusion plasma can be used to determine plasma properties and diagnose fusion performance. In this thesis, several analysis methods for neutron spectroscopy are presented and applied to data from the experimental fusion device JET. JET has numerous instruments for neutron measurements installed, and data from several of them are used in this thesis.The work presented here describes how various plasma parameters affect the neutron emission and how this information can be used to determine properties of the fusion plasma. Forward fitting of models parameterized in terms of the relevant plasma properties are a central part of most of the analysis methods and are used to determine key features of supra-thermal (“fast”) ion distributions for prediction of plasma performance in deuterium-tritium (d-t) experiments, and to determine the branching ratio for the formation of a short-lived 5He resonance in t+t reactions. The thesis also includes work concerning uncertainty quantification of the modeling of the neutron emission rate and the calculation of pile-up distortion of light-yield spectra from liquid scintillator detectors.A major contribution of this thesis is the novel methods for measuring properties of a fast-ion distribution using neutron spectroscopy with multiple sightlines. The combination of data from instruments viewing different parts of the plasma and/or with different viewing angles permits us to study fast-ion behavior in a more consistent and detailed fashion than if we analyze each measurement separately. Another interesting result is the first-ever observation of the neutron spectrum from t+t reactions in a magnetically confined fusion plasma, from which we can learn important things about the t+t reaction in reactor relevant conditions.
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| 11. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Campbell, PJ, et al.
(författare)
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Pan-cancer analysis of whole genomes
- 2020
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 578:7793, s. 82-
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Tidskriftsartikel (refereegranskat)abstract
- Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale1–3. Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4–5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter4; identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation5,6; analyses timings and patterns of tumour evolution7; describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity8,9; and evaluates a range of more-specialized features of cancer genomes8,10–18.
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| 17. |
- Kazakov, Ye O., et al.
(författare)
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Physics and applications of three-ion ICRF scenarios for fusion research
- 2021
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Ingår i: Physics of Plasmas. - : American Institute of Physics (AIP). - 1070-664X .- 1089-7674. ; 28:2
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Forskningsöversikt (refereegranskat)abstract
- This paper summarizes the physical principles behind the novel three-ion scenarios using radio frequency waves in the ion cyclotron range of frequencies (ICRF). We discuss how to transform mode conversion electron heating into a new flexible ICRF technique for ion cyclotron heating and fast-ion generation in multi-ion species plasmas. The theoretical section provides practical recipes for selecting the plasma composition to realize three-ion ICRF scenarios, including two equivalent possibilities for the choice of resonant absorbers that have been identified. The theoretical findings have been convincingly confirmed by the proof-of-principle experiments in mixed H–D plasmas on the Alcator C-Mod and JET tokamaks, using thermal 3He and fast D ions from neutral beam injection as resonant absorbers. Since 2018, significant progress has been made on the ASDEX Upgrade and JET tokamaks in H–4He and H–D plasmas, guided by the ITER needs. Furthermore, the scenario was also successfully applied in JET D–3He plasmas as a technique to generate fusion-born alpha particles and study effects of fast ions on plasma confinement under ITER-relevant plasma heating conditions. Tuned for the central deposition of ICRF power in a small region in the plasma core of large devices such as JET, three-ion ICRF scenarios are efficient in generating large populations of passing fast ions and modifying the q-profile. Recent experimental and modeling developments have expanded the use of three-ion scenarios from dedicated ICRF studies to a flexible tool with a broad range of different applications in fusion research.
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| 19. |
- Torretta, Nicholas B., 1988-, et al.
(författare)
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Pluriversal spaces for decolonizing design : exploring decolonial directions for participatory design
- 2023
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Ingår i: Diseña. - : Pontificia Universidad Católica de Chile. - 0718-8447 .- 2452-4298. ; 22:2, s. 3-18
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Tidskriftsartikel (refereegranskat)abstract
- Decolonization is a situated effort as it relates to the relations of privilege, power, politics, and access (3P-A, in Albarrán González’s terms) between the people involved in design in relation to wider societies. This complexity creates certain challenges for how we can understand, learn about, and nurture decolonization in design towards pluriversality, since such decolonizing effort is based on the relationship between specific individuals and the collective. In this paper, we present and discuss the ‘River project’, a participatory space for decolonizing design, created for designers and practitioners to reflect on their own 3P-A as a way to create awareness of their own oppressive potential in design work. These joint reflections challenged ideas of participation and shaped learning processes between the participants, bringing to the foreground the importance of seeing and allowing for a plurality of life and work worlds to be brought together. We build on the learnings from this project to propose the notions of pluriversal participation, pluriversal presence, and pluriversal directionality, which can help nurture decolonizing designs towards pluriversality. We conclude by arguing that, for nurturing pluriversality through Participatory Design, participation, presence, and direction must be equally pluriversal.
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| 20. |
- Veganzones Muñoz, José Javier, 1989-
(författare)
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Bridge Overhang Slabs with Edge Beams : LCCA and Structural Analysis for the Development of New Concepts
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bridge edge beams are associated with high life-cycle costs because of the need of maintenance, which also causes traffic disturbances. For this reason, the Swedish Transport Administration started a project to find better solutions. One of the proposals was a design without edge beam. However, the edge beam contributesto the load distribution and its removal would imply a loss of robustness, especially in bridges with overhang slabs. The efficiency of this effect depends onthe width of the overhang slab. Moreover, the width of the slab in itself, even inthe absence of an edge beam, may influence the load capacity of the structure. These aspects are paramount for the performance of tests that study the shear capacity of overhang slabs and assess design methods.The aim of this thesis is to contribute to the development of functional edge beam solutions in terms of cost and investigate the structural behavior of bridge overhang slabs with edge beams. A life-cycle cost analysis was the method to evaluate and identify edge beam alternatives that could qualify for further studies, including the use of stainless steel. Non-linear FE-analyses validated from experimental tests were used to investigate the influence of this member and the width of the overhang slab on the structural behavior under concentrated loads. Recommendations for minimal widths that ensure full load capacity of experimental specimens and an assessment of the existing calculation methods with special emphasis on the effective width were also studied.The outcome led to the implementation of new edge beam solutions. The results showed that the influence of the edge beam is not only quantitative due to its load-carrying function but also qualitative as it may affect the failure mode. The load capacity increased with the width until a threshold was reached. The mechanisms behind were the increase of shear capacity and the distribution of the forces sideways, with an eventual redistribution. Recommendations for minimal widths that ensure full capacity were presented for its consideration in the design of experimental tests, with or without edge beams. Effective widths are practical for a preliminary design but may lead to unreliable estimates. Modified approaches given the control section and the presence of an edge beam were proposed.
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