| 341. |
- Wadsten, Mats Å, et al.
(författare)
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The Buttazzoni Classification of Distal Radial Fractures in Adults : interobserver and Intraobserver Reliability
- 2009
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Ingår i: Hand. - : SAGE Publications. - 1558-9447 .- 1558-9455. ; 4:3, s. 283-288
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Tidskriftsartikel (refereegranskat)abstract
- Despite the fact that distal radial fracture is the commonest fracture, there is a little evidence-based knowledge about the value of its classification to guide management and predict prognosis. The available classification systems are either complicated or weakly applicable in clinical practice. Older's classification is the most reliable, but does not cover all radial fracture types. We evaluated the interobserver and intraobserver reliability of a new classification system which is a modification of Older's classification covering all radial fracture types. Two hundred and thirty-two consecutive adult patients with acute distal radial fractures were blindly evaluated according to the new classification by three orthopedic surgeons twice with 1-year interval. The interobserver reliability was measured using the Fleiss kappa coefficient, and the intraobserver reliability was measured using the Cohen's kappa coefficient. The new classification showed fair to substantial interobserver and intraobserver reliability, i.e., results comparable to the reliability of commonly used classification systems. The reliability was better for younger patients and when evaluation was carried out by hand-surgery-interested orthopedic surgeons. The new classification system is simple, covers all radial fracture types, and has an acceptable reliability. Further studies are needed to judge its ability to direct management and predict prognosis.
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| 342. |
- Wahlström, Claes-Göran, et al.
(författare)
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Supersonic jets of hydrogen and helium for laser wakefield acceleration
- 2016
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Ingår i: Physical Review Accelerators and Beams. - 2469-9888. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- The properties of laser wakefield accelerated electrons in supersonic gas flows of hydrogen and helium are investigated. At identical backing pressure, we find that electron beams emerging from helium show large variations in their spectral and spatial distributions, whereas electron beams accelerated in hydrogen plasmas show a higher degree of reproducibility. In an experimental investigation of the relation between neutral gas density and backing pressure, it is found that the resulting number density for helium is ∼30% higher than for hydrogen at the same backing pressure. The observed differences in electron beam properties between the two gases can thus be explained by differences in plasma electron density. This interpretation is verified by repeating the laser wakefield acceleration experiment using similar plasma electron densities for the two gases, which then yielded electron beams with similar properties.
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| 343. |
- Waldau, Susanne, 1954-
(författare)
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Creating organisational capacity for priority setting in health care : using a bottom-up approach to implement a top-down policy decision
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this thesis, priority setting to the form of the Swedish parliamental decision on priority setting, 1997, is considered an innovation for implementation in health care. The features of this innovation are investigated. The practical implications of implementation are identified by investigating the user organisation, ie, Swedish health care organisations and management systems. Also, a case of a three-stage process for macro-level priority setting that engaged the entire organisation in the Västerbotten County Council (VCC) is presented. This is done against a background of preceding implementation efforts in the VCC. Four specific research efforts and papers are presented. In Paper I, priority setting is operationalised into a multi-dimensional resource allocation task. On that basis, with the help of interviews (1998) and surveys (2002 and 2005) primarily of VCC health care managers, the impact of implementation is measured by prioritisation structures, processes and decisions. Survey response rates were low. Results were used as qualitative data, internally compared, and interpreted as: a) responses reflected mainly “early adopters’” opinions; b) priority setting is an ambiguous concept; c) indicating limited overall implementation; d) reinterpretation of the prioritisation task occurred over time among respondents; and, e) this group took increasingly personal responsibility as stakeholders in priority setting. Paper II reports a case study intervention of explicit, departmental level priority setting with the aim of improving cost-effectiveness in in vitro fertilization resource use and a rationing of services perceived legitimate by all stakeholders. The intervention combined priority setting and structured quality improvement techniques. Results were: a) improved operational efficiency of diagnostic procedures that allowed resources to be reallocated to treatment; and b) patients were prioritized and treatment resources were rationed based on evidence of treatment effect among subgroups. Evaluation showed that the procedure met stated criteria for legitimacy. In Paper III, a full-format test of the macro level prioritisation process is described and evaluated by participants with the help of surveys after each completed stage. Participants report the need for improvement of elements in the overall process and of procedural specifics. However, overall there was a strong commitment to the initiative and satisfaction with the process and the resulting decisions. In Paper IV, procedural specifics of the prioritisation process are evaluated. They are also compared to the Program Budgeting and Marginal Analysis (PBMA) framework when used for macro level purposes. Procedures provided intended results such as vertical and horizontal priority setting and a consistent process. However, economic targets were not fully achieved in any of the stages. Conclusions include that health care management systems are not prepared for priority setting and need profound restructuring and that the prioritisation process described in Papers III and IV was successful because: a) the process satisfied politicians’ directives; b) participants were satisfied with the procedures and perceived the subsequent reallocation decisions as legitimate; and, c) methods resulted in the intended outcome. Factors suggested as the basis of success include: long-term overall preparations; broad and deep participation; a readiness for change among participants; a stage for horizontal priority setting that added to the quality, feasibility and perceived validity of the knowledge base; a strong process leadership; and politicians determined to protect the process from opportunistic disturbances.
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| 344. |
- Walinder, Göran, et al.
(författare)
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Outcome and characteristics of non-measurable myeloma : A cohort study with population-based data from the Swedish Myeloma Registry
- 2020
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Ingår i: European Journal of Haematology. - : Wiley. - 0902-4441 .- 1600-0609. ; 104:5, s. 376-382
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Tidskriftsartikel (refereegranskat)abstract
- Objective We describe survival in patients with oligo- and non-secretory multiple myeloma (MM). We refer to the whole group as non-measurable MM and compare it with secretory MM. Methods Oligo-secretory MM was defined as M protein in serum <10 g/L and M protein in urine <200 measured as mg/day, mg/liter or mg/mmol creatinine. If patients had no M protein, they were defined as non-secretory. The groups were also subdivided by Free Light Chains (SFLC) level and ratio. Results Out of 4325 patients with symptomatic MM in the Swedish Myeloma Registry during 2008-2016 eligible for the study, 389 patients (9%) had non-measurable MM. Out of these, 253 patients (6%) had oligo-secretory and 136 (3%) had non-secretory MM. Median survival for secretory MM was 42.7 months, non-measurable MM 40.2 months, oligo-secretory MM 38.6 months, and non-secretory MM 44.6 months. Difference in overall observed survival was non-significant for all groups when compared with secretory MM. Within non-secretory MM, stem cell transplantation (SCT), 95% being auto-SCT, was significant for superior survival in multivariate analysis (HR 0.048. P = .0015). Conclusion In this population-based study, we found no difference in survival between oligo- or non-secretory MM when compared with secretory MM. SCT appears to be important also for patients with non-secretory disease.
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| 345. |
- Wang, Hong-Lei, et al.
(författare)
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Identification of the sex pheromone of the spruce seed moth, Cydia strobilella L.
- 2010
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Ingår i: Journal of Chemical Ecology. - : Springer Science and Business Media LLC. - 1573-1561 .- 0098-0331. ; 36:3, s. 305-313
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Tidskriftsartikel (refereegranskat)abstract
- The spruce seed moth, Cydia strobilella L., is a serious pest on cones of spruce (Picea spp.) in the Holarctic region. Previous studies from different parts of its area of distribution have reported conflicting results on the composition of its sex pheromone. By gas chromatography with electroantennographic detection, coupled gas chromatography-mass spectrometry, a Y-tube olfactometer bioassay, and field trials, the sex pheromone of Swedish populations of the species was identified as (8E,10E)-dodecadienyl acetate and (8E,10Z)-dodecadienyl acetate. About 0.5 pg of each pheromone component was extracted per female. The most attractive blend of EE- and EZ-isomers was about 6:4, respectively, and 0.3 microg of the blend per rubber septum was the most attractive dosage for field trapping. Monounsaturated components previously reported as sex pheromone components/attractants for C. strobilella, (E)-8-dodecenyl acetate in Canadian populations and (Z)-8-dodecenol in Polish and Dutch populations, did not attract any C. strobilella in this study. Large numbers of C. jungiella Clerck were trapped by using (8E,10Z)-dodecadienyl acetate alone, whereas (Z)-8-dodecenol attracted Pammene splendidulana Guenée and P. rhediella Clerck.
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| 346. |
- Waters, Rafael, et al.
(författare)
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Experimental results from sea trials of an offshore wave energy system
- 2007
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Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 90:3, s. 034105-
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Tidskriftsartikel (refereegranskat)abstract
- A full-scale prototype of a wave power plant has been installed off the Swedish west coast and the overall wave energy converter concept has been verified. Initial results have been collected and significant insights discovered. Energy absorption dependency on load as well as output voltage and power is demonstrated. It is shown that great overload capability of the directly driven linear generator is critical, and indicated that, for resistive loads, optimal load does not vary with wave climate. Future grid supplying energy production would necessitate parks of wave power plants in order to reduce power fluctuations.
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| 347. |
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| 348. |
- Waters, Rafael, et al.
(författare)
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Ocean wave energy absorption in response to wave period and amplitude : offshore experiments on a wave energy converter
- 2011
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Ingår i: IET Renewable Power Generation. - : IEEE Press. - 1752-1416. ; 5:6, s. 465-469
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Tidskriftsartikel (refereegranskat)abstract
- The ability of a wave energy converter to capture the energy of ocean waves has been studied in offshore experiments. This study covers 50 days during which the converter was subjected to ocean waves over a wide range of frequencies and amplitudes as well as three different electrical loads. The results present the wave energy converter??s energy absorption as a function of significant wave height, energy period and electrical load. It is shown that the power generated overall continues to increase with wave amplitude, whereas the relative absorption decreases towards the highest periods and amplitudes. The absorption reached a maximum of approximately 24% with the used combination of buoy, generator and electrical load. Absorption to cover for iron and mechanical losses has not been included. A brief study of the nature of the electromagnetic damping force has also been included in the study. The wave energy converter is of the technology that is being researched at Uppsala University and experimented on off the Swedish west coast at the Lysekil wave energy research site.
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| 349. |
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| 350. |
- Westberg, Sara, et al.
(författare)
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Treatment Efficacy and Immune Stimulation by AdCD40L Gene Therapy of Spontaneous Canine Malignant Melanoma
- 2013
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Ingår i: Journal of immunotherapy (1997). - 1524-9557 .- 1537-4513. ; 36:6, s. 350-358
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Tidskriftsartikel (refereegranskat)abstract
- Malignant melanoma is a serious disease in both humans and dogs, and the high metastatic potential results in poor prognosis for many patients. Its similarities with human melanoma make spontaneous canine melanoma an excellent model for comparative studies of novel therapies and tumor biology. We report a pilot study of local adenovector CD40L (AdCD40L) immunogene treatment in 19 cases of canine melanoma (14 oral, 4 cutaneous, and 1 conjunctival). Three patients were World Health Organization stage I, 2 were stage II, 10 stage III, and 4 stage IV. One to 6 intratumoral injections of AdCD40L were given every 7 days, followed by cytoreductive surgery in 9 cases and only immunotherapy in 10 cases. Tumor tissue was infiltrated with T and B lymphocytes after treatment, suggesting immune stimulation. The best overall response included 5 complete responses, 8 partial responses, and 4 stable and 2 progressive disease statuses according to the World Health Organization response criteria. Median survival was 160 days (range, 20-1141 d), with 3 dogs still alive at submission. Our results suggest that local AdCD40L therapy is safe and could have beneficial effects in dogs, supporting further treatment development. Clinical translation to human patients is in progress.
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