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| 2. |
- Aktas, A., et al.
(author)
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Tests of QCD factorisation in the diffractive production of dijets in deep-inelastic scattering and photoproduction at HERA
- 2007
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In: European Physical Journal C. Particles and Fields. - : Springer Science and Business Media LLC. - 1434-6044. ; 51:3, s. 549-568
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Journal article (peer-reviewed)abstract
- Measurements are presented of differential dijet cross sections in diffractive photoproduction (Q(2) < 0.01 GeV2) and deep-inelastic scattering processes (DIS, 4 < Q2 < 80 GeV2). The event topology is given by ep -> eXY, in which the system X, containing at least two jets, is separated from a leading low-mass baryonic system Y by a large rapidity gap. The dijet cross sections are compared with NLO QCD predictions based on diffractive parton densities previously obtained from a QCD analysis of inclusive diffractive DIS cross sections by H1. In DIS, the dijet data are well described, supporting the validity of QCD factorisation. The diffractive DIS dijet data are more sensitive to the diffractive gluon density at high fractional parton momentum than the measurements of inclusive diffractive DIS. In photoproduction, the predicted dijet cross section has to be multiplied by a factor of approximately 0.5 for both direct and resolved photon interactions to describe the measurements. The ratio of measured dijet cross section to NLO prediction in photoproduction is a factor 0.5 +/- 0.1 smaller than the same ratio in DIS. This suppression is the first clear observation of QCD hard scattering factorisation breaking at HERA. The measurements are also compared to the two soft colour neutralisation models SCI and GAL. The SCI model describes diffractive dijet production in DIS but not in photoproduction. The GAL model fails in both kinematic regions.
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- Al-Shammari, I., et al.
(author)
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Implementation of an international standardized set of outcome indicators in pregnancy and childbirth in Kenya: Utilizing mobile technology to collect patient-reported outcomes
- 2019
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:10
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Journal article (peer-reviewed)abstract
- Background Limited data exist on health outcomes during pregnancy and childbirth in low- and middleincome countries. This is a pilot of an innovative data collection tool using mobile technology to collect patient-reported outcome measures (PROMs) selected from the International Consortium of Health Outcomes Measurement (ICHOM) Pregnancy and Childbirth Standard Set in Nairobi, Kenya. Methods Pregnant women in the third trimester were recruited at three primary care facilities in Nairobi and followed prospectively throughout delivery and until six weeks postpartum. PROMs were collected via mobile surveys at three antenatal and two postnatal time points. Outcomes included incontinence, dyspareunia, mental health, breastfeeding and satisfaction with care. Hospitals reported morbidity and mortality. Descriptive statistics on maternal and child outcomes, survey completion and follow-up rates were calculated. Results In six months, 204 women were recruited: 50% of women returned for a second ante-natal care visit, 50% delivered at referral hospitals and 51% completed the postnatal visit. The completion rates for the five PROM surveys were highest at the first antenatal care visit (92%) and lowest in the postnatal care visit (38%). Data on depression, dyspareunia, fecal and urinary incontinence were successfully collected during the antenatal and postnatal period. At six weeks postpartum, 86% of women breastfeed exclusively. Most women that completed the survey were very satisfied with antenatal care (66%), delivery care (51%), and post-natal care (60%). Conclusion We have demonstrated that it is feasible to use mobile technology to follow women throughout pregnancy, track their attendance to pre-natal and post-natal care visits and obtain data on PROM. This study demonstrates the potential of mobile technology to collect PROM in a low-resource setting. The data provide insight into the quality of maternal care services provided and will be used to identify and address gaps in access and provision of high quality care to pregnant women. © 2019 Al-Shammari et al.
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| 5. |
- Anderson, Danielle L., et al.
(author)
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Spatial and temporal distribution of gamma H2AX fluorescence in human cell cultures following synchrotron-generated X-ray microbeams : lack of correlation between persistent gamma H2AX foci and apoptosis
- 2014
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In: Journal of Synchrotron Radiation. - 0909-0495 .- 1600-5775. ; 21, s. 801-810
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Journal article (peer-reviewed)abstract
- Formation of gamma H2AX foci (a marker of DNA double-strand breaks), rates of foci clearance and apoptosis were investigated in cultured normal human fibroblasts and p53 wild-type malignant glioma cells after exposure to high-dose synchrotron-generated microbeams. Doses up to 283 Gy were delivered using beam geometries that included a microbeam array (50 mu m wide, 400 mu m spacing), single microbeams (60-570 mu m wide) and a broad beam (32 mm wide). The two cell types exhibited similar trends with respect to the initial formation and time-dependent clearance of gamma H2AX foci after irradiation. High levels of gamma H2AX foci persisted as late as 72 h post-irradiation in the majority of cells within cultures of both cell types. Levels of persistent foci after irradiation via the 570 mu m microbeam or broad beam were higher when compared with those observed after exposure to the 60 mu m microbeam or microbeam array. Despite persistence of gamma H2AX foci, these irradiation conditions triggered apoptosis in only a small proportion (<5%) of cells within cultures of both cell types. These results contribute to the understanding of the fundamental biological consequences of high-dose microbeam irradiations, and implicate the importance of non-apoptotic responses such as p53-mediated growth arrest (premature senescence).
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| 7. |
- Armonaite, Laura
(author)
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Malpositioned and dislocated intraocular lenses : management, complications and surgical repositioning
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Cataract surgery (exchange of the non-transparent crystalline lens with an IOL) is the most frequent surgery in Sweden, accounting for more than 130000 surgeries per year. Therefore, complications associated with cataract surgery affect a significant number of patients. One of the complications is IOL dislocation, meaning that the IOL is not located at the central part of the optical zone, which often causes visual impairment. The overall aim of this thesis was to deepen knowledge about dislocated IOLs, especially surgery of out-of-the-bag and in-the-bag dislocated IOLs and management of uveitis-glaucoma-hyphema (UGH) syndrome. Study I had a retrospective case-control design with a total of 32 patients, and included out-of-the-bag dislocated IOL. The aim was to evaluate the efficacy and safety of 3-piece IOL suturing to the iris. The case group (n=14; Iris group) underwent dislocated out-of-the-bag 3-piece IOL suturing to the iris. The control group (n=18; Exchange group) underwent IOL exchange with a new IOL sutured to the sclera. The groups were followed in the median of 13.5 (interquartile range (IQR) 10–20) and 12.5 (IQR 10–14) months, respectively. Best corrected visual acuity (BCVA) improved significantly in each group with no significant difference in either final BCVA or final intraocular pressure (IOP) between the groups. Complication frequency was similar in the groups. Surgically induced corneal astigmatism (SIA) and number of postoperative visits were significantly lower in the Iris group. Study II, a prospective randomized clinical trial with a cross-sectional part, included in-the-bag dislocated IOL. A total of 177 patients were analyzed in this study. The aim was to evaluate three-dimensional (3-D) IOL position, refractive change, and IOL-induced astigmatism (IIA), also importance of capsular fibrosis on postoperative IOL position after IOL suturing to the sclera (2.5 mm behind the limbus) using 2 surgical methods: Ab Externo Scleral Suture Loop Fixation (Group A) and a modification, Embracing the Continuous Curvilinear Capsulorhexis (CCC), a technique created by L.A. (Group B). Additionally, the study evaluated the usefulness of swept-source anterior segment optical coherence tomography (SS–AS-OCT) for measuring 3-D IOL position. A total of 117 patients (117 eyes) with in-the-bag dislocated IOL were randomized into Group A (n=61) or Group B (n=56). The control group consisted of patients with ordinary pseudophakia (n=60). The median IOL tilt did not significantly differ between Group A (7.8°, IQR 5.9°–12.0°) and Group B (8.3°, IQR 6.4°–10.8°) but each group was significantly different from the ordinary pseudophakia (5.4°, IQR 3.9°–7.1°) by the mean of 3.75° (CI (confidence interval) 2.54°–4.95°). The direction of IOL tilt was inferotemporal in 87%–87.5% of patients in each of the three groups, and a mirror symmetry was observed between the left and right eyes. IOL surgery resulted in significant myopic shift. In eyes without capsular fibrosis, the median IOL tilt was 15.5° (IQR 7.8°–21.7°) in Group A (n=7) and 7.0° (IQR 6.6°–11.4°) in Group B (n=5) although without a statistically significant difference. IIA was 0.075 D for each degree of IOL tilt, which was statistically significant. Five patients (three in Group A and two in Group B, of which one IOL was dislocated by intraocular gas) were re-operated after their one-month follow-up visit. IOL position could be measured with SS–AS-OCT in all cases if the IOL could be seen in the pupil. It was also possible to measure and quantify the capsular bag thickness. Study III focused on UGH syndrome, and had a retrospective case-control design with a cross-sectional part and a descriptive part. A total of 213 patients were included. The study comprised both out-of-the-bag and in-the-bag dislocations as well as other types of IOL malpositions; however, all causing UGH syndrome. The study aimed to evaluate the effect of UGH treatment, a need for IOP-lowering treatment, clinical manifestation (including iris-IOL contact signs) and usage of blood thinners (anticoagulants and antiaggregants), also, which examination–clinical, AS-OCT, or ultrasound biomicroscopy (UBM)–was the most effective tool to diagnose UGH syndrome. Three groups of patients were compared: UGH syndrome (n=71), dislocated IOL without UGH (n=71) and uncomplicated pseudophakia (n=71). Surgical treatment was effective in approximately 77% of cases. IOP and BCVA improved significantly in the operated patients but not in the non-operated patients. In total, 51% of all patients (57% of operated patients) needed IOP-lowering therapy after UGH resolution, and IOP≥22 mmHg at the first (1st) hemorrhage was the only significant predictor identified for this. Pseudophacodonesis (IOL-donesis) was seen in 22.5% of patients at the beginning of UGH syndrome, and was significantly more frequent than in the Pseudophakic group. Transilluminating iris defects (TID) in the UGH group were not more frequent than in the Dislocated group at the beginning of UGH. However, the shape of TIDs differed significantly: haptic or optic edge formed TIDs were seen more frequently in the UGH group. Patients with UGH syndrome did not use blood thinners more frequently than patients in Dislocated group, except Warfarin (Waran®). Examination on a slit-lamp, AS-OCT, and UBM showed iris-IOL contact in 97%, 19%, and 21% of patients, respectively. Conclusions: Suturing out-of-the-bag dislocated 3-piece IOL to the iris is a safe and effective surgical treatment with less SIA and fewer postoperative visits to an ophthalmologist than IOL exchange. Suturing in-the-bag dislocated IOL to the sclera results in good IOL position with both surgical methods, although the position differs from the normal pseudophakia by approximately 3.75° which has little clinical significance as IOL-tilt induced astigmatism is low. However, IOL suturing to the sclera induces myopic shift in cases when the IOL is sutured 2.5 mm behind the limbus. A new study with more patients without capsular fibrosis would show whether IOL position is better with the modified method than with the traditional one in this subgroup. SS–AS-OCT is useful for 3-D IOL position quantification after IOL repositioning. Surgical treatment does not guarantee resolution of UGH syndrome, though BCVA results are better than with conservative treatment. IOL-donesis is a risk factor for UGH syndrome. The impact of Warfarin (Waran®) on UGH development should be investigated further, although other blood thinners probably do not increase the risk for UGH syndrome. TIDs are not specific to UGH syndrome unless they are formed like the haptic or optic edge. Every second patient may need IOP-lowering therapy; IOP≥22 mmHg at the first hemorrhage predicts the need for IOP-lowering treatment in a long run (after UGH resolution). Follow up time should be long after UGH resolution. Clinical examination was more useful for detecting iris-IOL contact than AS-OCT or UBM in study III.
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| 8. |
- Armonaite, Laura, et al.
(author)
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Repositioning of in-the-bag dislocated intraocular lenses : a randomized clinical trial comparing two surgical methods
- 2023
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In: Ophthalmic Research. - : S. Karger. - 0030-3747 .- 1423-0259. ; 66:1, s. 590-598
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Journal article (peer-reviewed)abstract
- Introduction: The aim of this study was to evaluate intraocular lens (IOL) tilt, IOL-induced astigmatism (IIA), refractive change, and impact of capsular fibrosis on IOL position after scleral fixation of dislocated IOL using two methods: ab externo scleral suture loop fixation (group A) and a modification, embracing the continuous curvilinear capsulorhexis (group B).Methods: In this prospective randomized clinical trial conducted at St. Erik Eye Hospital, 117 patients with dislocated IOL were randomized to group A (n = 61) or B (n = 56). Patients with ordinary pseudophakia (n = 60) served as controls. IOL tilt was measured three-dimensionally with anterior segment optical coherence tomography (AS-OCT).Results: The median IOL tilt was similar with both methods (A: 7.8°; B: 8.3°; p = 0.51) but higher than in ordinary pseudophakia (5.4°; p < 0.001). Both groups showed a myopic shift, p < 0.001. In cases without capsular fibrosis, the median IOL tilt was 15.5° in group A (n = 7) and 7.0° in group B (n = 5), p = 0.19. For each degree of IOL tilt, IIA increased by 0.075 D (p < 0.001). IOL position could be measured with AS-OCT in all patients given that the IOL was visible in the pupil.Conclusion: After IOL fixation surgery, IOL tilt is higher than in normal pseudophakia. A study involving more patients without capsular fibrosis could clarify whether IOL position is better with method B in this subgroup. IAA is low, but myopic shift is common. AS-OCT is useful for IOL tilt assessment after IOL fixation surgery.
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| 9. |
- Armonaite, Laura, et al.
(author)
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Seventy-one cases of uveitis-glaucoma-hyphaema syndrome
- 2021
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In: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 99:1, s. 69-74
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Journal article (peer-reviewed)abstract
- PURPOSE: To assess Uveitis-Glaucoma-Hyphaema syndrome (UGH syndrome) with focus on resolution, glaucoma development and risk factors.METHODS: This retrospective case-control study with a cross-sectional component was performed to compare three groups with 71 patients each: UGH syndrome, dislocated intraocular lens (IOL) without UGH syndrome and ordinary pseudophakia. Main outcome measures were resolution of the UGH syndrome, best-corrected visual acuity (BCVA) and the need of glaucoma therapy. We also assessed the IOL-iris contact signs and the use of blood thinners.RESULTS: Uveitis-Glaucoma-Hyphaema (UGH) syndrome resolved in 77 % of patients who underwent various kind of IOL surgery. Intraocular pressure (IOP) decreased and BCVA improved in the operated cases (p = 0.02 and p < 0.001, respectively), but not in the cases treated conservatively. Intraocular pressure (IOP) ≥22 mmHg at the first haemorrhage predicted the need of glaucoma therapy after UGH syndrome resolution (p = 0.002, area under the curve = 0.8). Fifty-one per cent of patients without preexisting glaucoma needed glaucoma therapy after UGH syndrome resolution. Pseudophacodonesis was seen more frequently in the UGH group than in the ordinary pseudophakia group (p = 0.001). Iris defects were not more frequent in the UGH group than in the Dislocated group but the types of defects differed (p < 0.0001). Blood thinners were not more frequent in UGH.CONCLUSION: In UGH syndrome, the results are better with surgical intervention than with conservative treatment, but surgery does not guarantee resolution. Pseudophacodonesis is a risk factor for UGH syndrome, but blood thinners are not, and iris defects are not specific to UGH syndrome. A high IOP at the first haemorrhage increases the risk for needing subsequent IOP-lowering therapy.
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