| 1. |
- Frostfeldt, Gunnar, et al.
(författare)
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Low molecular weight heparin (Dalteparin) as adjuvant treatment to thrombolysis in acute myocardial infarction-a pilot study : BIOchemical markers in acute coronary syndromes (BIOMACS II)
- 1999
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Ingår i: Journal of the American College of Cardiology. - 0735-1097 .- 1558-3597. ; 33:3, s. 627-633
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This randomized, double blind, placebo-controlled pilot trial evaluated the effect of dalteparin as an adjuvant to thrombolysis in patients with acute myocardial infarction regarding early reperfusion, recurrent ischemia and patency at 24 h. BACKGROUND: Low-molecular-weight heparin, given subcutaneously twice daily without monitoring, might be an attractive alternative to conventional intravenous heparin in the treatment of acute myocardial infarction. METHODS: In 101 patients dalteparin/placebo 100 IU/kg was given just before streptokinase and a second injection 120 IU/kg after 12 h. Monitoring with continuous vector-ECG was done to obtain signs of early reperfusion and later ischemic episodes. Blood samples for myoglobin were obtained at start and after 90 min to evaluate signs of reperfusion. Coronary angiography was performed after 20-28 h to evaluate TIMI-flow in the infarct-related artery. RESULTS: Dalteparin added to streptokinase tended to provide a higher rate of TIMI grade 3 flow in infarct-related artery compared to placebo, 68% versus 51% (p = 0.10). Dalteparin had no effects on noninvasive signs of early reperfusion. In patients with signs of early reperfusion, there seemed to be a higher rate of TIMI grade 3 flow, 74% versus 46% (myoglobin) (p = 0.04) and 73% versus 52% (vector-ECG) (p = 0.11). Ischemic episodes 6-24 h. after start of treatment were fewer in the dalteparin group, 16% versus 38% (p = 0.04). CONCLUSIONS: When dalteparin was added as an adjuvant to streptokinase and aspirin, there were tendencies for less ECG monitoring evidence of recurrent ischemia and better patency at 24 h, warranting further study.
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| 2. |
- Ahlberg, Gunnar
(författare)
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The role of simulation technology for skills acquisition in image guided surgery
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Technical proficiency is an essential ingredient in surgical competence, which has hitherto been poorly evaluated. The introduction of disruptive technology into the Operating Room (OR) with respect to operative procedures requires an equally disruptive paradigm shift in surgical training that matches the development in OR technology. Automation and overcoming difficulties in navigating these technologies, is probably best achieved outside the OR and, therefore, the conventional apprenticeship model does not fit well with the development of such skills. Simulators have been a part of the aviation training curriculum for over 70 years and this technology has now confronted surgical education. In all fields where simulators have been implemented, error reduction has been the major driving force and the surgical discipline is no exception. In fact, medical errors have become a significant source of patient risk, and increasing complexity, as in surgical care, implies increasing error proneness. The effect of simulator training with respect to transfer of skills from the simulated environment to the OR is of crucial interest if this technology is to reach compulsory status in surgical education. The general aim of this study was to investigate the possible role of simulation technology as an integral component in future educational programs in image guided surgery. Paper I describes a randomised, controlled study where laparoscopic skills were assessed for a group of novices performing, under supervision of an experienced laparoscopic surgeon, in a porcine model in the OR. All procedures were videotaped and reviewed. Performance in the simulator was demonstrated to correlate with performance in the operating room. In a prospective study design. Paper II deals with the learning curve for laparoscopic fundoplication in a group of surgical trainees during the performance of their first 20 supervised procedures. Three independent observers assessed the operations, giving scores for essential parts of the procedure. The shape of the individual's learning curve varied immensely and the level of the teaching surgeon seemed to limit the pupil's possibility to reach a high grade. Papers III and IV were randomised, controlled trials where skills transfer from Virtual Reality (VR) to OR was studied. Simulator-trained subjects performed significantly better during their first 10 colonoscopies (Paper III) and in their first 10 laparoscopic cholecystectomies (Paper IV), as compared to the respective control groups. In conclusion, we have demonstrated that novice performance measured in a VR-simulator seems to predict the ultimate performance in the OR. Moreover, proficiency-based training facilitated skills transfer to the actual clinical environment, thereby, constituting a training curriculum that greatly improves the initial learning curve in endoscopic procedures. Thus, as a result of these studies the AccuTouch® and the LapSim® systems can now be considered as clinically validated for this purpose. In addition, the performance level of the teaching surgeon seemed to greatly influence the proficiency level attainable by the surgeon in training. We believe that the objective methods for assessing technical skills in the OR developed in this study, and by others, will provide the possibility to explore the link between technical performance and patient outcome. Furthermore, the results in this study strongly support the ongoing implementation of simulation technology for skills acquisition and assessment in image-guided surgery.
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| 3. |
- Ahlberg, Mats Steinholtz, et al.
(författare)
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Time without PSA recurrence after radical prostatectomy as a predictor of future biochemical recurrence, metastatic disease and prostate cancer death : a prospective Scandinavian cohort study
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:12
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Tidskriftsartikel (refereegranskat)abstract
- Objective: 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 of prostate cancer death. We investigated the long-term probabilities of PSA recurrence, metastases and prostate cancer death in patients without biochemical recurrence five and 10 years after radical prostatectomy.Design: Prospective cohort study. Stratification by Gleason score (<= 3+4=7or >= 4+3=7), pathological tumour stage (pT2 or >= pT3) and negative or positive surgical margins.Setting: Between 1989 and 1998, 14 urological centres in Scandinavia randomised patients to the Scandinavian Prostate Cancer Group study number 4 (SPCG-4) trial.ParticipationAll 306 patients from the SPCG-4 trial who underwent radical prostatectomy within 1year from inclusion were eligible. Four patients were excluded due to surgery-related death (n=1) or salvage radiotherapy or hormonal treatment within 6weeks from surgery (n=3).Primary outcome measures: 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 24 years. Median preoperative PSA was 9.8ng/mL and median age 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=7and 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 >= 3versus pT2 and for positive versus negative surgical margins. Limitations include small size of the cohort.Conclusion: Many patients with favourable histopathology without biochemical recurrence 5years after radical prostatectomy could stop follow-up earlier than 10 years after radical prostatectomy.
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| 4. |
- Ahmed, Istaq, 1972, et al.
(författare)
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Structural study and proton conductivity in Yb-doped BaZrO3
- 2007
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Ingår i: Solid State Ionics. - 0167-2738. ; 178:(7-10), s. 515-520
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Tidskriftsartikel (refereegranskat)abstract
- Traditional solid state sintering has been used to prepare the perovskite BaZr0.9Yb0.1O3-delta. Analysis of X-ray powder diffraction data shows that an increase of the unit cell parameter, a, was observed compared to undoped BaZrO3. Rietveld analysis of room temperature neutron powder diffraction data confirmed cubic symmetry (space group Pm-3m). Dynamic thermogravimetric analysis (TGA) indicates that the hydration process occurs below 200 degrees C. The strong O-H stretch band, 2500-3500 cm(-1), in the infrared absorbance spectrum clearly manifests the presence of protons in the hydrated material. Proton conductivity was investigated on hydrated and as-prepared samples under dry and wet atmospheres, respectively. Keywords: X-ray diffraction; neutron diffraction; Rietveld refinement; proton conductor; perovskite
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| 5. |
- Ahmed, Istaq, 1972, et al.
(författare)
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Synthesis and structural characterization of perovskite type proton conducting BaZr1-xInxO3-delta (0.0 <= x <= 0.75)
- 2006
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Ingår i: Solid State Ionics. - : Elsevier BV. - 0167-2738 .- 1872-7689. ; 177:17-18, s. 1395-1403
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Tidskriftsartikel (refereegranskat)abstract
- Solid state sintering has been used to prepare the cubic perovskite structured compounds BaZr1-xInxO3-delta (0.0 <= x <= 0.75). Analysis of X-ray powder diffraction (XRPD) data reveals that the unit cell parameter, a, increases linearly with an increased Indium concentration. XRPD data was also used to demonstrate the completion of sample hydration, which was reached when the materials showed a set of single-phase Bragg-peaks. Dynamic thermogravimetric analysis (TGA) data showed that approx. 89% of the total number of available oxygen vacancies can be filled in BaZr1-xInxO3-delta for x=0.50, and that the maximum water uptake occurs below 300 degrees C. Rietveld analysis of the room temperature neutron powder diffraction (NPD) data confirmed the average cubic symmetry (space group Pm-3m), and an expansion of the unit cell parameter after the hydration reaction. The strong O-H stretch band, 2500-3500 cm(-1), in the infrared absorbance spectrum clearly manifests the presence of protons in the hydrated material. Proton conductivity of hydrated BaZr1-xInxO3-delta, x=0.75 was investigated during heating and cooling cycles under dry argon atmosphere. The total conductivity during the heating cycle was nearly two orders of magnitude greater than that of cooling cycle at 300 degrees C, whilst these values were similar at higher temperatures i.e. T > 600 degrees C.
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| 6. |
- Arkitektur & teknik 2020/21, Årskurs 3, et al.
(författare)
-
Resedagbok Schweiz augusti 2021
- 2021
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Arkitektur och tekniks årliga studieresa till Schweiz är på många sätt unik. Vi transporterar oss själva genom det vackra alplandskapet och besöker några av landets vackraste broar och byggnader. De vilda bergsmassiven och den förfinade byggnadskulturen väver sig in i varandra under hela vår magiska arkitektursafari. Resan i augusti 2021 blev nästan ett år försenad på grund av pandemin. I stället för en förberedelse av studierna i årskurs 3 blev det en festlig avslutning på kandidattiden på Chalmers. Vid sidan om våra gängse besöksmål, från Robert Maillarts och Jürg Conzetts konstruktioner till Le Corbusier och Peter Zumthors arkitektur, hade vi den här resan ett särskilt fokus på materialen lera, kalk, sten och cement, och på restaurering av broar och byggnader i dessa material.
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| 7. |
- Blimark, Cecilie, et al.
(författare)
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Outcome and survival of myeloma patients diagnosed 2008-2015. Real-world data on 4904 patients from the Swedish Myeloma Registry
- 2018
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Ingår i: Haematologica. - : Ferrata Storti Foundation (Haematologica). - 0390-6078 .- 1592-8721. ; 103:3, s. 506-513
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Tidskriftsartikel (refereegranskat)abstract
- Epidemiology and outcome of myeloma are mainly reported from large university centers and collaborative groups, and do not represent 'real-world' patients. The Swedish Myeloma Registry is a prospective population-based registry documenting characteristics, treatment and outcome in newly diagnosed myeloma, including asymptomatic and localized forms, with the purpose of improving disease management and outcome. This report presents information on patients diagnosed between 2008 and 2015, including data on first-line treatment in patients diagnosed up to 2014, with a follow up until December 2016. We present age-adjusted incidence, patients' characteristics at baseline, treatment, response, and survival. Baseline data were available with a 97% coverage in 4904 patients (median age 71 years, males 70 years, females 73 years; 72% were 65 years or older), and at 1-year follow up in 3558 patients with symptomatic disease (92% of patients initially reported). The age-adjusted incidence was 6.8 myeloma cases per 100,000 inhabi-ants per year. Among initially symptomatic patients (n= 3988), 77% had osteolytic lesions or compression fractures, 49% had anemia, 18% impaired kidney function, and 13% hypercalcemia. High-dose therapy with autologous stem cell transplantation was given to 77% of patients aged up to 66 years, and to 22% of patients aged 66-70 years. In the study period, 68% received bortezomib, thalidomide, and/or lenalidomide as part of the first-line treatment, rising from 31% in 2008 to 81% in 2014. In active myeloma, the median relative survival of patients aged 65 years or under was 7.7 years, and 3.4 years in patients aged 66 years and over. Patients diagnosed with myeloma in more recent years were associated with significantly higher rates of complete or very good partial remission (P<0.05), and with a significantly higher survival, with a Hazard Ratio (HR) of 0.84 (95% CI: 0.77-0.92; P<0.05). There was a small, but significant survival benefit in patients treated at university hospitals (HR 0.93; 95% CI: 0.87-0.99; P<0.05). We report here on a near complete 'real-world' population of myeloma patients during an 8-year period; a period in which newer drugs were implemented into standard practice. The overall incidence and median age were both higher than in most previous studies, indicating a more complete coverage of older patients. Myeloma survival in Sweden is comparable to other large registry studies, and responses and survival improved during the study period.
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| 8. |
- Calner, Mikael, et al.
(författare)
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Från kusten till djuphavet
- 2006
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Ingår i: Geobiosfären - en introduktion. - 9789144036700 ; , s. 315-322
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Crawley, C, et al.
(författare)
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Outcomes for reduced-intensity allogeneic transplantation for multiple myeloma: an analysis of prognostic factors from the Chronic Leukaemia Working Party of the EBMT
- 2005
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Ingår i: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 105:11, s. 4532-4539
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Tidskriftsartikel (refereegranskat)abstract
- We report the outcome of 229 patients who received an allograft for myeloma with reduced-intensity conditioning (RIC) regimens from 33 centers within the European Group for Blood and Marrow Transplantation (EBMT). The median age was 52 years and 64% were male. Conditioning regimens were heterogeneous, but most were fludarabine based and T cell depleted with antithymocyte globulin or alemtuzumab. Transplantation-related mortality (TRIM) at 1 year was 22%. The 3-year overall survival (OS) and progression-free survival (PFS) were 41% and 21 %, respectively. Adverse OS was associated with chemoresistant disease (relative risk [RR], 2.9), more than 1 prior transplantation (RR, 2.0), and male patients with female donors (FIR, 1.45). Adverse PFS was associated with chemoresistance (RR, 2.4) and alemtuzumab (RR, 1.8). TRM was increased with female-to-male donation (RR, 2.5) and transplantation more than 1 year from diagnosis (RR, 2.3). Grades II to IV acute graft-versus-host disease (aGvHD) occurred in 31%. Chronic GvHD was associated with better OS and PFS and were 84% and 46% for limited, 58% and 30% for extensive, and 29% and 12% in its absence suggesting that a graft-versus-myeloma effect is important. While RIC is feasible, heavily pretreated patients and patients with progressive disease do not benefit.
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| 10. |
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| 11. |
- Gimsing, Peter, et al.
(författare)
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Effect of pamidronate 30 mg versus 90 mg on physical function in patients with newly diagnosed multiple myeloma (Nordic Myeloma Study Group): a double-blind, randomised controlled trial
- 2010
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Ingår i: LANCET ONCOLOGY. - : Elsevier Science B.V., Amsterdam.. - 1470-2045 .- 1474-5488. ; 11:10, s. 973-982
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Tidskriftsartikel (refereegranskat)abstract
- Background Compared with placebo, prophylactic treatment with bisphosphonates reduces risk of skeletal events in patients with multiple myeloma. However, because of toxicity associated with long-term bisphosphonate treatment, establishing the lowest effective dose is important. This study compared the effect of two doses of pamidronate on health-related quality of life and skeletal morbidity in patients with newly diagnosed multiple myeloma. Methods This double-blind, randomised, phase 3 trial was undertaken at 37 clinics in Denmark, Norway, and Sweden. Patients with multiple myeloma who were starting antimyeloma treatment were randomly assigned in a 1:1 ratio to receive one of two doses of pamidronate (30 mg or 90 mg) given by intravenous infusion once a month for at least 3 years. Randomisation was done by use of a central, computerised minimisation system. Primary outcome was physical function after 12 months estimated by the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire (scale 0-100). All patients who returned questionnaires at 12 months and were still on study treatment were included in the analysis of the primary endpoint. This study is registered with ClinicalTrials. gov, number NCT00376883. Findings From January, 2001, until August, 2005, 504 patients were randomly assigned to pamidronate 30 mg or 90 mg (252 in each group). 157 patients in the 90 mg group and 156 in the 30 mg group were included in the primary analysis. Mean physical function at 12 months was 66 points (95% CI 62.9-70.0) in the 90 mg group and 68 points (64.6-71.4) in the 30 mg group (95% CI of difference -6.6 to 3.3; p=0.52). Median time to first skeletal-related event in patients who had such an event was 9.2 months (8.1-10.7) in the 90 mg group and 10-2 months (7.3-14.0) in the 30 mg group (p=0.63). In a retrospective analysis, eight patients in the pamidronate 90 mg group developed osteonecrosis of the jaw compared with two patients in the 30 mg group. Interpretation Monthly infusion of pamidronate 30 mg should be the recommended dose for prevention of bone disease in patients with multiple myeloma.
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| 12. |
- Hamoir, Dominique, et al.
(författare)
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Results of ACTIM: an EDA study on spectral laser imaging
- 2011
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Ingår i: Proc. SPIE 8186, Electro-Optical Remote Sensing, Photonic Technologies, and Applications V. - : SPIE - International Society for Optical Engineering. - 9780819488145 ; , s. Art.nr 8186A-25-
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Konferensbidrag (refereegranskat)abstract
- The European Defence Agency (EDA) launched the Active Imaging (ACTIM) study to investigate the potential of active imaging, especially that of spectral laser imaging. The work included a literature survey, the identification of promising military applications, system analyses, a roadmap and recommendations. Passive multi- and hyper-spectral imaging allows discriminating between materials. But the measured radiance in the sensor is difficult to relate to spectral reflectance due to the dependence on e.g. solar angle, clouds, shadows... In turn, active spectral imaging offers a complete control of the illumination, thus eliminating these effects. In addition it allows observing details at long ranges, seeing through degraded atmospheric conditions, penetrating obscurants (foliage, camouflage…) or retrieving polarization information. When 3D, it is suited to producing numerical terrain models and to performing geometry-based identification. Hence fusing the knowledge of ladar and passive spectral imaging will result in new capabilities. We have identified three main application areas for active imaging, and for spectral active imaging in particular: (1) long range observation for identification, (2) mid-range mapping for reconnaissance, (3) shorter range perception for threat detection. We present the system analyses that have been performed for confirming the interests, limitations and requirements of spectral active imaging in these three prioritized applications.
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| 13. |
- Hedenus, Michael, et al.
(författare)
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Addition of intravenous iron to epoetin beta increases hemoglobin response and decreases epoetin dose requirement in anemic patients with lymphoproliferative malignancies : a randomized multicenter study
- 2007
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Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 0887-6924 .- 1476-5551. ; 21:4, s. 627-632
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Tidskriftsartikel (refereegranskat)abstract
- This randomized study assessed if intravenous iron improves hemoglobin (Hb) response and permits decreased epoetin dose in anemic (Hb 9 - 11 g/dl), transfusion-independent patients with stainable iron in the bone marrow and lymphoproliferative malignancies not receiving chemotherapy. Patients (n = 67) were randomized to subcutaneous epoetin beta 30 000 IU once weekly for 16 weeks with or without concomitant intravenous iron supplementation. There was a significantly (P < 0.05) greater increase in mean Hb from week 8 onwards in the iron group and the percentage of patients with Hb increase >= 2 g/dl was significantly higher in the iron group (93%) than in the no-iron group (53%) (per-protocol population; P < 0.001). Higher serum ferritin and transferrin saturation in the iron group indicated that iron availability accounted for the Hb response difference. The mean weekly patient epoetin dose was significantly lower after 13 weeks of therapy (P < 0.029) and after 15 weeks approximately 10 000 IU (425%) lower in the iron group, as was the total epoetin dose (P = 0.051). In conclusion, the Hb increase and response rate were significantly greater with the addition of intravenous iron to epoetin treatment in iron-replete patients and a lower dose of epoetin was required.
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| 14. |
- Jensen, Ulf J., et al.
(författare)
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The role of a simulator-based course in coronary angiography on performance in real life cath lab
- 2014
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 14, s. 49-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to explore if a course consisting of lectures combined with simulator training in coronary angiography (CA) could accelerate the early learning curve when performing CA on patients. Knowledge in performing CA is included in the curriculum for the general cardiologist. The method, according to American College of Cardiology and European Society of Cardiology guidelines, for this training is not well defined but simulator training is proposed to be an option. However, the transfer effect from a CA simulator to performance in real world cath lab is not validated. Methods: Fifty-four residents without practical skills in CA completed the course and 12 continued to training in invasive cardiology. These residents were tracked in the Swedish Coronary Angiography and Angioplasty Registry and compared to a control group of 46 novel operators for evaluation of performance metrics. A total of 4472 CAs were analyzed. Results: Course participants demonstrated no consistent acceleration in the early learning curve in real world cath lab. They had longer fluoroscopy time compared to controls (median 360 seconds (IQR 245-557) vs. 289 seconds (IQR 179-468), p < 0.001). Safety measures also indicated more complications appearing at the ward, in particular when using the femoral approach (6.25% vs. 2.53%, p < 0.001). Conclusions: Since the results of this retrospective non-randomized study were negative, the role of a structured course including simulator training for skills acquisition in CA is still uncertain. Randomized transfer studies are warranted to justify further use of simulators for training in CA
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| 15. |
- Jensen, Ulf, et al.
(författare)
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Technical Skills Assessment in a Coronary Angiography Simulator for Construct Validation.
- 2013
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Ingår i: Simulation in Healthcare: the Journal of the Society for Simulation in Healthcare. - 1559-713X. ; 8:5, s. 324-328
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The aim of this study was to evaluate technical skills in a coronary angiography (CA) simulator to establish the performance level of trainees and experts in virtual CA.The traditional master-apprentice way of learning CA is by practicing on patients despite a known risk for complications during training. Safe CA training is warranted, and simulators might be one possibility. Simulators used must be validated regarding their ability to separate trainees from experts. Construct validation of a CA simulator, to our knowledge, has not yet been published. METHODS: Ten cardiology residents without experience in CA, 4 intermediate, and 10 CA experts performed 5 CAs in the Mentice VIST (Vascular Intervention Simulation Trainer). Metrics reflecting proficiency skills such as total procedure time, fluoroscopy time, and contrast volume were extracted from the simulator computer and compared between the groups. All examinations were videotaped, and the number of handling errors was examined. The videos were evaluated by 2 experts blinded to the test object's performance level. RESULTS: Experts outperformed trainees in all metrics measured by the simulator. Improvement was demonstrated in all metrics through all 5 CAs. Furthermore, beginners had more handling errors compared with experts. CONCLUSIONS: Mentice VIST simulator can distinguish between trainees and experts in CA in the metrics extracted from the computer and therefore prove the concept of construct validity.
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| 16. |
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| 17. |
- Pálsson, Gunnar K., et al.
(författare)
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Hydrogen site occupancy and strength of forces in nanosized metal hydrides
- 2012
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Ingår i: Physical Review B. Condensed Matter and Materials Physics. - 1098-0121 .- 1550-235X. ; 85:19, s. 195407-
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Tidskriftsartikel (refereegranskat)abstract
- The dipole force components in nanosized metal hydrides are quantitatively determined with curvature and x-ray diffraction measurements. Ab initio density functional theory is used to calculate the dipole components and the symmetry of the strain field. The hydrogen occupancy in a 100-nm-thick V film is shown to be tetrahedral with a slight asymmetry at low concentration, and a transition to octahedral occupancy is shown to take place at around 0.07 [H/V] at 360 K. When the thickness of the V layer is reduced to 3 nm and biaxially strained, in a Fe0.5V0.5/V superlattice, the hydrogen unequivocally occupies octahedral z-like sites, even at and below concentrations of 0.02 [H/V].
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| 18. |
- van Dongen, Koen W, et al.
(författare)
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European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills.
- 2010
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Ingår i: Surgical endoscopy. - : Springer Science and Business Media LLC. - 1432-2218 .- 0930-2794. ; 25:1, s. 166-171
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Virtual reality (VR) simulators have been demonstrated to improve basic psychomotor skills in endoscopic surgery. The exercise configuration settings used for validation in studies published so far are default settings or are based on the personal choice of the tutors. The purpose of this study was to establish consensus on exercise configurations and on a validated training program for a virtual reality simulator, based on the experience of international experts to set criterion levels to construct a proficiency-based training program. METHODS: A consensus meeting was held with eight European teams, all extensively experienced in using the VR simulator. Construct validity of the training program was tested by 20 experts and 60 novices. The data were analyzed by using the t test for equality of means. RESULTS: Consensus was achieved on training designs, exercise configuration, and examination. Almost all exercises (7/8) showed construct validity. In total, 50 of 94 parameters (53%) showed significant difference. CONCLUSIONS: A European, multicenter, validated, training program was constructed according to the general consensus of a large international team with extended experience in virtual reality simulation. Therefore, a proficiency-based training program can be offered to training centers that use this simulator for training in basic psychomotor skills in endoscopic surgery.
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| 19. |
- Waage, Anders, et al.
(författare)
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Melphalan and prednisone plus thalidomide or placebo in elderly patients with multiple myeloma
- 2010
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Ingår i: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 116:9, s. 1405-1412
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Tidskriftsartikel (refereegranskat)abstract
- In this double-blind, placebo-controlled study, 363 patients with untreated multiple myeloma were randomized to receive either melphalan-prednisone and thalidomide (MPT) or melphalan-prednisone and placebo (MP). The dose of melphalan was 0.25 mg/kg and prednisone was 100 mg given daily for 4 days every 6 weeks until plateau phase. The dose of thalidomide/placebo was escalated to 400 mg daily until plateau phase and thereafter reduced to 200 mg daily until progression. A total of 357 patients were analyzed. Partial response was 34% and 33%, and very good partial response or better was 23% and 7% in the MPT and MP arms, respectively (P < .001). There was no significant difference in progression-free or overall survival, with median survival being 29 months in the MPT arm and 32 months in the MP arm. Most quality of life outcomes improved equally in both arms, apart from constipation, which was markedly increased in the MPT arm. Constipation, neuropathy, non-neuropathy neurologic toxicity, and skin reactions were significantly more frequent in the MPT arm. The number of thromboembolic events was equal in the 2 treatment arms. In conclusion, MPT had a significant antimyeloma effect, but this did not translate into improved survival. This trial was registered at www.clinicaltrials.
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| 20. |
- Wiklund, Ingela, et al.
(författare)
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Routine testing of umbilical cord blood after normal delivery should be discontinued
- 2014
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 5:4, s. 165-166
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Tidskriftsartikel (refereegranskat)abstract
- On many newborns in Sweden routine samples of blood are taken from the umbilical cord after birth to measure the acid-base balance. These tests were introduced with the aim to objectively measure the well-being and stress levels of the newborn. The information was to be used as a measurement of quality of care, for research and as a tool to help guide decisions around the care-needs of the newborn. After 10 years of routine analysis it has become clear that the results of these tests have limited clinical value and that they are a poor measurement of quality of care. © 2014 Elsevier B.V.
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