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Sökning: WFRF:(Beck Marc)

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21.
  • Janko, Matthew, et al. (författare)
  • Contemporary Outcomes After Partial Resection of Infected Aortic Grafts
  • 2021
  • Ingår i: Annals of Vascular Surgery. - : Elsevier. - 0890-5096 .- 1615-5947. ; 76, s. 202-210
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Aortic graft infection remains a considerable clinical challenge, and it is unclear which variables are associated with adverse outcomes among patients undergoing partial resection.METHODS: A retrospective, multi-institutional study of patients who underwent partial resection of infected aortic grafts from 2002 to 2014 was performed using a standard database. Baseline demographics, comorbidities, operative, and postoperative variables were recorded. The primary outcome was mortality. Descriptive statistics, Kaplan-Meier (KM) survival analysis, and Cox regression analysis were performed.RESULTS: One hundred fourteen patients at 22 medical centers in 6 countries underwent partial resection of an infected aortic graft. Seventy percent were men with median age 70 years. Ninety-seven percent had a history of open aortic bypass graft: 88 (77%) patients had infected aortobifemoral bypass, 18 (16%) had infected aortobiiliac bypass, and 1 (0.8%) had an infected thoracic graft. Infection was diagnosed at a median 4.3 years post-implant. All patients underwent partial resection followed by either extra-anatomic (47%) or in situ (53%) vascular reconstruction. Median follow-up period was 17 months (IQR 1, 50 months). Thirty-day mortality was 17.5%. The KM-estimated median survival from time of partial resection was 3.6 years. There was no significant survival difference between those undergoing in situ reconstruction or extra-anatomic bypass (P = 0.6). During follow up, 72% of repairs remained patent and 11% of patients underwent major amputation. On univariate Cox regression analysis, Candida infection was associated with increased risk of mortality (HR 2.4; P = 0.01) as well as aortoenteric fistula (HR 1.9, P = 0.03). Resection of a single graft limb only to resection of abdominal (graft main body) infection was associated with decreased risk of mortality (HR 0.57, P = 0.04), as well as those with American Society of Anesthesiologists classification less than 3 (HR 0.35, P = 0.04). Multivariate analysis did not reveal any factors significantly associated with mortality. Persistent early infection was noted in 26% of patients within 30 days postoperatively, and 39% of patients were found to have any post-repair infection during the follow-up period. Two patients (1.8%) were found to have a late reinfection without early persistent postoperative infection. Patients with any post-repair infection were older (67 vs. 60 years, P = 0.01) and less likely to have patent repairs during follow up (59% vs. 32%, P = 0.01). Patients with aortoenteric fistula had a higher rate of any post-repair infection (63% vs. 29%, P < 0.01)CONCLUSION: This large multi-center study suggests that patients who have undergone partial resection of infected aortic grafts may be at high risk of death or post-repair infection, especially older patients with abdominal infection not isolated to a single graft limb, or with Candida infection or aortoenteric fistula. Late reinfection correlated strongly with early persistent postoperative infection, raising concern for occult retained infected graft material.
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22.
  • Janko, Matthew R., et al. (författare)
  • In situ bypass and extra-anatomic bypass procedures result in similar survival in patients with secondary aortoenteric fistulas
  • 2021
  • Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 73:1, s. 210-221.e1
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The optimal revascularization modality in secondary aortoenteric fistula (SAEF) remains unclear in the literature. The purpose of this investigation was to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients with SAEF. Methods: A retrospective, multi-institutional study of SAEF from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and operative and postoperative variables were recorded. The primary outcome was long-term mortality. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariate analyses were performed. Results: During the study period, 182 patients at 34 institutions from 11 countries presented with SAEF (median age, 72 years; 79% male). The initial aortic procedures that resulted in SAEF were 138 surgical grafts (76%) and 42 endografts (23%), with 2 unknown; 102 of the SAEFs (56%) underwent complete excision of infected aortic graft material, followed by in situ (in-line) bypass (ISB), including antibiotic-soaked prosthetic graft (53), autogenous femoral vein (neoaortoiliac surgery; 17), cryopreserved allograft (28), and untreated prosthetic grafts (4). There were 80 patients (44%) who underwent extra-anatomic bypass (EAB) with infected graft excision. Overall median Kaplan-Meier estimated survival was 319 days (interquartile range, 20-2410 days). Stratified by EAB vs ISB, there was no significant difference in Kaplan-Meier estimated survival (P = .82). In comparing EAB vs ISB, EAB patients were older (74 vs 70 years; P = .01), had less operative hemorrhage (1200 mL vs 2000 mL; P = .04), were more likely to initiate dialysis within 30 days postoperatively (15% vs 5%; P = .02), and were less likely to experience aorta-related hemorrhage within 30 days postoperatively (3% aortic stump dehiscence vs 11% anastomotic rupture; P = .03). There were otherwise no significant differences in presentation, comorbidities, and intraoperative or postoperative variables. Multivariable Cox regression showed that the duration of antibiotic use (hazard ratio, 0.92; 95% confidence interval, 0.86-0.98; P = .01) and rifampin use at time of discharge (hazard ratio, 0.20; 95% confidence interval, 0.05-0.86; P = .03) independently decreased mortality. Conclusions: These data suggest that ISB does not offer a survival advantage compared with EAB and does not decrease the risk of postoperative aorta-related hemorrhage. After repair, <50% of SAEF patients survive 10-months. Each week of antibiotic use decreases mortality by 8%. Further study with risk modeling is imperative for this population. (J Vasc Surg 2021;73:210-21.)
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23.
  • Janko, Matthew R., et al. (författare)
  • In-situ bypass is associated with superior infection-free survival compared with extra-anatomic bypass for the management of secondary aortic graft infections without enteric involvement
  • 2022
  • Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 76:2, s. 546-
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The optimal revascularization modality following complete resection of aortic graft infection (AGI) without enteric involvement remains unclear. The purpose of this investigation is to determine the revascularization approach associated with the lowest morbidity and mortality using real-world data in patients undergoing complete excision of AGI. Methods: A retrospective, multi-institutional study of AGI from 2002 to 2014 was performed using a standardized database. Baseline demographics, comorbidities, and perioperative variables were recorded. The primary outcome was infection-free survival. Descriptive statistics, Kaplan-Meier survival analysis, and univariate and multivariable analyses were performed. Results: A total of 241 patients at 34 institutions from seven countries presented with AGI during the study period (median age, 68 years; 75% male). The initial aortic procedures that resulted in AGI were 172 surgical grafts (71%), 66 endografts (27%), and three unknown (2%). Of the patients, 172 (71%) underwent complete excision of infected aortic graft material followed by in situ (in-line) bypass (ISB), including antibiotic-treated prosthetic graft (35%), autogenous femoral vein (neo-aortoiliac surgery) (24%), and cryopreserved allograft (41%). Sixty-nine patients (29%) underwent extra-anatomic bypass (EAB). Overall median Kaplan-Meier estimated survival was 5.8 years. Perioperative mortality was 16%. When stratified by ISB vs EAB, there was a significant difference in Kaplan-Meier estimated infection-free survival (2910 days; interquartile range, 391-3771 days vs 180 days; interquartile range, 27-3750 days; P <.001). There were otherwise no significant differences in presentation, comorbidities, or perioperative variables. Multivariable Cox regression showed lower infection-free survival among patients with EAB (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.6-3.6; P <.001), polymicrobial infection (HR, 2.2; 95% CI, 1.4-3.5; P = .001), methicillin-resistant Staphylococcus aureus infection (HR, 1.7; 95% CI, 1.1-2.7; P = .02), as well as the protective effect of omental/muscle flap coverage (HR, 0.59; 95% CI, 0.37-0.92; P = .02). Conclusions: After complete resection of AGI, perioperative mortality is 16% and median overall survival is 5.8 years. EAB is associated with nearly a two and one-half-fold higher reinfection/mortality compared with ISB. Omental and/or muscle flap coverage of the repair appear protective.
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24.
  • Keil, M, et al. (författare)
  • Development and characterization of silane antisticking layers on nickel-based stamps designed for nanoimprint lithography
  • 2005
  • Ingår i: Journal of Vacuum Science and Technology B. - : American Vacuum Society. - 1520-8567. ; 23:2, s. 575-584
  • Tidskriftsartikel (refereegranskat)abstract
    • In this study we will report on the development of a process to establish antisticking layers on nickel-based stamps, which are used in several industrial applications of nanoimprint lithography or related methods. The fluorinated alkyl silane films have been deposited onto different Ni-based stamp surfaces in order to minimize the adhesion tendency at the stamp/polymer interface. film thickness, chemical composition, purity, and binding mechanisms of the silane groups to different stamp surface materials have been determined by photoelectron spectroscopy (XPS). In the case of electroplated nickel stamps-where low imprint qualities are observed-multilayer thick films cover, the stamp surfaces, consisting of polymerized, cross-linked alkyl silanes, which are poorly bound to the surface. In order to overcome these restrictions a. 100 angstrom thick polycrystalline titanium layer has been established in a sandwich position between the nickel substrate and the silane film. Here, silane film thicknesses in the monomolecular region together with evidences for strong covalent linkage between the silane groups and the oxidized Ti surface can be concluded from the XPS results, leading to film properties and imprint qualities, which are comparable to those formerly observed for silicon stamps.
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25.
  • Keil, M, et al. (författare)
  • Process development and characterization of antisticking layers on nickel-based stamps designed for nanoimprint lithography
  • 2004
  • Ingår i: Journal of Vacuum Science and Technology B. - : American Vacuum Society. - 1520-8567. ; 22:6, s. 3283-3287
  • Tidskriftsartikel (refereegranskat)abstract
    • Thin films of different derivatives of fluorinated alkyl phosphoric acids have been deposited from aqueous solutions onto surfaces of oxidized polycrystalline nickel stamps. which are commonly used in several industrial applications of nanoimprint lithography (NIL). The films have been established in order to increase the antiadhesion tendencies at the stamp polymer interface. Thicknesses, chemical compositions, and purities of the films as well as binding mechanisms to the stamp surfaces have been determined by photoelectron spectroscopy (XPS). The results demonstrate the adsorption of highly pure films having thicknesses in the monomolecular region, whose chemical compositions are characterized by large ratios of fluorinated to nonfluorinated carbon species. The high ionic nature of Ni-oxide benefits strong ionic linkages between the phosphate groups of the fluorinated antisticking film and the stamp surface, allowing a large-scale production of imprints with patterned stamps having feature sizes down to 100 nm. (C) 2004 American Vacuum Society.
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26.
  • Lee, Natuschka N, et al. (författare)
  • The extreme biology of meteorites : their role in understanding the origin and distribution of life on earth and in the Universe
  • 2017. - 2
  • Ingår i: Adaption of microbial life to environmental extremes. - Cham : Springer Publishing Company. - 9783319483252 - 9783319483276 ; , s. 283-325
  • Bokkapitel (refereegranskat)abstract
    • Meteorites have captured our fascination since our early history – they have evoked awe, fear, an irresistible curiosity, and numerous lively debates. Former historians have indicated that many of the ancient cultures and civilizations in Europe, Africa, Asia, the Inuit, and the native Indians in America regarded both the meteorite and the location of their fall as sacred. Thus, they used the meteorites as religious objects or for craft design like jewelry, weapons, or even practical things like tools and horse shoes. Today, meteorites continue to capture our fascination through popular cultural formats such as science fiction and also as a scientific window that reveals the secrets of the Solar System formation. Within academia, meteorites have always fomented keen scientific debate. It was not until the early nineteenth century that the cosmic origin of meteorites, i.e., being truly not tellurian, was approved by the scientific community after the late eighteenth-century work of Ernst F. Chladni (1794). This implied for the first time that there are other smaller bodies in the sky besides the Moon. After this, several other lively debates followed on controversial findings and hypotheses around the role of meteorites in the universe and for the evolutionary course of life on Earth, often in connection with the profound difficulties to approach this subject in an adequate scientific way. Principally the different types of meteorites (asteroids, meteors, etc.) can be viewed as a most extreme or exotic substrate, habitat, and transport mode of chemicals and possibly even of cell-based life forms for several reasons:(i)They have experienced a remarkable history since their origin as condensates from the Solar Nebula, more or less metamorphosed or molten fragments of asteroids, or rocks from Mars or our Moon.(ii)The meteorites have been exposed to multiple extreme conditions ranging from milliseconds to billions of years duration when traveling through the interplanetary space, until they fell down on an astronomical body like Earth.(iii)Once on Earth, the meteorites get exposed to different weathering conditions, which often makes it a challenge to retrieve their former history in an unambiguous way.
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27.
  • Ling, TGI, et al. (författare)
  • Fa-brication and characterization of a molecular adhesive layer for micro- and nanofabricated electrochemical electrodes
  • 2003
  • Ingår i: Microelectronic Engineering. - 1873-5568. ; 67-8, s. 887-892
  • Tidskriftsartikel (refereegranskat)abstract
    • In the microelectronics industry, gold electrodes on silicon dioxide are produced using an adhesive layer of chromium or titanium. This method is applicable whenever a dry environment is present. However, when such an electrode is exposed to an electrolyte a galvanic cell is formed and the less noble metal will dissolve and eventually destroy the electrode. We describe here how a monolayer of mercaptopropyl-trimethoxysilane (MPTS) can be used as an adhesive. The layer can be structured lithographically making gold electrodes in the micro- and nano-range applicable for use in electrochemistry. The properties of the MPTS layer were investigated with photoelectron microscopy, atomic force microscopy and the electrochemical performance of the gold electrodes was determined by cyclic voltammetry. (C) 2003 Elsevier Science B.V. All rights reserved.
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28.
  • Ling, T.G.I., et al. (författare)
  • The organic/inorganic interface: a study of direct electron transfer
  • 2002
  • Ingår i: 7th International Conference on Nanometer-Scale Science and Technology and 21st European Conference on Surface Science.
  • Konferensbidrag (refereegranskat)abstract
    • Porphyrins have become an interesting class of molecules in studies of molecular electronics. They are, however, sensitive to handling procedures and may give different results in electronic or optical properties depending on the method used for coupling or adsorption. We present electronic measurements of a heme porphyrin mounted in a biomolecular structure-an enzyme-and show that a direct electron transfer between the enzyme and the electrode results from a chemical reaction
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29.
  • Maximov, Ivan, et al. (författare)
  • Fabrication of Si-based nanoimprint stamps with sub-20 nm features
  • 2002
  • Ingår i: MICROELECTRONIC ENGINEERING. - 1873-5568 .- 0167-9317. ; 61-2, s. 449-454
  • Konferensbidrag (refereegranskat)abstract
    • We present two alternative methods for fabrication of nanoimprint lithography stamps in SiO2 with sub-20 nm features: (a) optimized electron beam lithography (EBL) and lift-off patterning of a 15-nm thick Cr mask, and (b) aerosol deposition of W particles in the 20-nm size range. In both cases, the pattern transfer into SiO2 was performed using reactive ion etching (RIE) with CHF3 as etch gas. In the first approach, we used a double layer resist system (PMMA/ZEP 520A7 positive resists) for the EBL exposure. Resist thickness, exposure dose and development time were optimized to obtain 15-20 nm features after Cr lift-off. In the second approach, we used size selected W aerosol particles as etch masks during etching of SiO2. Both methods of stamp fabrication are compared and discussed. (C) 2002 Published by Elsevier Science B.V.
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30.
  • Maximov, Ivan, et al. (författare)
  • Nanoimprint technology for fabrication of three-terminal ballistic junction devices in GaInAs/InP
  • 2003
  • Ingår i: Microelectronic Engineering. - 1873-5568. ; 67-8, s. 196-202
  • Tidskriftsartikel (refereegranskat)abstract
    • We present processing technology based on nanoimprint lithography (NIL) and wet etching for fabrication of GaInAs/InP three-terminal ballistic junction (TBJ) devices. To transfer sub-100 nm features into a high-mobility InP-based 2DEG material, we used SiO2/Si stamps made with electron beam lithography and reactive ion etching. After the NIL, the resist residues are removed in oxygen plasma followed by wet etching of GaInAs/InP to define the M-structures. Fabricated TBJ-devices are characterized using scanning electron microscopy and electron transport measurements. Highly non-linear electrical characteristics of the TBJ structures are demonstrated and compared with E-beam defined devices. (C) 2003 Elsevier Science B.V. All rights reserved.
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