| 1. |
- Choularton, T. W., et al.
(author)
-
The Great Dun Fell Cloud Experiment 1993 : An overview
- 1997
-
In: Atmospheric Environment. - 1352-2310. ; 31:16, s. 2393-2405
-
Journal article (peer-reviewed)abstract
- The 1993 Ground-based Cloud Experiment on Great Dun Fell used a wide range of measurements of trace gases, aerosol particles and cloud droplets at five sites to study their sources and sinks especially those in cloud. These measurements have been interpreted using a variety of models. The conclusions add to our knowledge of air pollution, acidification of the atmosphere and the ground, eutrophication and climate change. The experiment is designed to use the hill cap cloud as a flow-through reactor, and was conducted in varying levels of pollution typical of much of the rural temperate continental northern hemisphere in spring-time.
|
|
| 2. |
- Björklund, J., et al.
(author)
-
Scientific Merits and Analytical Challenges of Tree-Ring Densitometry
- 2019
-
In: Reviews of geophysics. - 8755-1209 .- 1944-9208. ; 57:4, s. 1224-1264
-
Research review (peer-reviewed)abstract
- X-ray microdensitometry on annually resolved tree-ring samples has gained an exceptional position in last-millennium paleoclimatology through the maximum latewood density (MXD) parameter, but also increasingly through other density parameters. For 50 years, X-ray based measurement techniques have been the de facto standard. However, studies report offsets in the mean levels for MXD measurements derived from different laboratories, indicating challenges of accuracy and precision. Moreover, reflected visible light-based techniques are becoming increasingly popular, and wood anatomical techniques are emerging as a potentially powerful pathway to extract density information at the highest resolution. Here we review the current understanding and merits of wood density for tree-ring research, associated microdensitometric techniques, and analytical measurement challenges. The review is further complemented with a careful comparison of new measurements derived at 17 laboratories, using several different techniques. The new experiment allowed us to corroborate and refresh long-standing wisdom but also provide new insights. Key outcomes include (i) a demonstration of the need for mass/volume-based recalibration to accurately estimate average ring density; (ii) a substantiation of systematic differences in MXD measurements that cautions for great care when combining density data sets for climate reconstructions; and (iii) insights into the relevance of analytical measurement resolution in signals derived from tree-ring density data. Finally, we provide recommendations expected to facilitate futureinter-comparability and interpretations for global change research.
|
|
| 3. |
- Björklund, Jesper, 1979, et al.
(author)
-
Scientific Merits and Analytical Challenges ofTree-Ring Densitometry
- 2019
-
In: Reviews of Geophysics. - : American Geophysical Union (AGU). - 8755-1209 .- 1944-9208. ; 57:4, s. 1224-1264
-
Journal article (peer-reviewed)abstract
- X-ray microdensitometry on annually resolved tree-ring samples has gained an exceptional position in last-millennium paleoclimatology through the maximum latewood density (MXD) parameter, but also increasingly through other density parameters. For 50 years, X-ray based measurement techniques have been the de facto standard. However, studies report offsets in the mean levels for MXD measurements derived from different laboratories, indicating challenges of accuracy and precision. Moreover, reflected visible light-based techniques are becoming increasingly popular, and wood anatomical techniques are emerging as a potentially powerful pathway to extract density information at the highest resolution. Here we review the current understanding and merits of wood density for tree-ring research, associated microdensitometric techniques, and analytical measurement challenges. The review is further complemented with a careful comparison of new measurements derived at 17 laboratories, using several different techniques. The new experiment allowed us to corroborate and refresh "long-standing wisdom" but also provide new insights. Key outcomes include (i) a demonstration of the need for mass/volume-based recalibration to accurately estimate average ring density; (ii) a substantiation of systematic differences in MXD measurements that cautions for great care when combining density data sets for climate reconstructions; and (iii) insights into the relevance of analytical measurement resolution in signals derived from tree-ring density data. Finally, we provide recommendations expected to facilitate futureinter-comparability and interpretations for global change research.
|
|
| 4. |
- Stirling, R., et al.
(author)
-
Global survey on durability variation – on the effect of the reference species
- 2016
-
In: Proceedings of the International Research Group Annual Meeting 2016.
-
Conference paper (other academic/artistic)abstract
- Climate change due to anthropogenic emissions is the largest environmental challenge of ourtime. Forest-based value chains play an important role in reducing the accumulation of CO2 in the atmosphere. Maximizing the use of wood to tackle climate change requires improved understanding of the service life of timber products. This information can best be obtained from field testing and while there is an abundance of field performance data from sites all over the world, most of the data are not available in a form that can be utilised for service life models.The IRG Durability Database aims to improve the usability of existing performance data and create added value for durability research and service life prediction. The present paper takes the first steps in comparing global field test performance data from the IRG Durability Database for non-durable reference species. Data were obtained from six species above ground and ground contact field tests from 36 sites around the world. For each dataset, decay rates and service life (where applicable) were calculated. Datasets were then grouped together based on test method and species. Decay rate was faster and more uniform in ground contact than above ground. Inground contact, beech decayed most rapidly, followed by Norway spruce and Scots pines apwood. All appeared to be suitable for use as reference species, however slow-grown spruce should be avoided. There were no statistically significant correlations between ground contact decay rate and the Scheffer Climate Index (SCI). In above ground tests, differences in decay ratewere largely related to differences in moisture dynamics. Species with the greatest absorption and retention of water decayed most rapidly. Test methods that absorbed and retained the most moisture (e.g. painted L-joints) resulted in more rapid decay. Above ground decay rate and SCI were significantly correlated in two data sets that had a wide range of SCI values. Correlations were not significant when only European test sites were included. Estimating decay rate from field testing results in highly variable data. Comparing data from global test sites is made more difficult by the absence of common field testing standards.
|
|
| 5. |
|
|
| 6. |
- Andersen, J. N., et al.
(author)
-
Intermixing in the Na on Al(111) system
- 1992
-
In: Physical Review Letters. - 0031-9007. ; 68:1, s. 94-97
-
Journal article (peer-reviewed)abstract
- Ordered structures formed by Na adsorption on the Al(111) surface are investigated by high-resolution core-level spectroscopy. It is shown that, contrary to the common picture of alkali adsorption, two of the structures formed at room temperature consist of intermixed Na-Al layers. The results for the (3 ×)-rotated-30°structure are also consistent with intermixing although they do not provide any definite proof. For Na layers deposited at 100 K no intermixing is found.
|
|
| 7. |
|
|
| 8. |
- Elango, M., et al.
(author)
-
Autoionization phenomena involving the 2p53d configuration of argonlike ions in ionic solids
- 1993
-
In: Physical Review B (Condensed Matter). - 0163-1829. ; 47:18, s. 11736-11748
-
Journal article (peer-reviewed)abstract
- The photon-induced Auger and photoelectron spectra of the argonlike ions Cl- (in NaCl), K+ (in KCl), Ca2+ (in CaCl2 and CaF2), and Sc3+ (in Sc2O3) have been measured in the vicinity of the L23 absorption edges of these ions. It is shown that at the 2p6→2p53d(4s) resonance a spectator structure appears in the L23M23M23 Auger spectra, which shifts to higher kinetic energies with increasing photon energy. This structure originates from the 3p-23d(4s) final configuration arising as a product of the Auger resonant-inelastic-scattering process of the incident photons. We demonstrate that the peculiarities of this process and the role of the collapsing 3d electron in it can be largely understood in terms of an atomic treatment. The solid-state effects, caused by the crystal field and the lattice polarization, may play an additional role.
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
- Nyholm, R., et al.
(author)
-
Surface core-level shifts of the Al(100) and Al(111) surfaces
- 1991
-
In: Physical Review B (Condensed Matter). - 0163-1829. ; 44:19, s. 10987-10990
-
Journal article (peer-reviewed)abstract
- The surface core-level shifts of the Al(100) and Al(111) surfaces have been measured by high-resolution photoelectron spectroscopy. For the Al(100) surface we obtain a value of (-965) meV. This value is in excellent agreement with a recent ab initio calculation by Feibelman. The surface core-level shift of the Al(111) surface is found to be close to zero, and an upper limit of 15 meV is obtained.
|
|
| 14. |
- Pickwell, K., et al.
(author)
-
Minor amputation does not negatively affect health-related quality of life as compared with conservative treatment in patients with a diabetic foot ulcer : An observational study
- 2017
-
In: Diabetes/Metabolism Research and Reviews. - : Wiley. - 1520-7552. ; 33:3
-
Journal article (peer-reviewed)abstract
- Background: Health-related quality of life (HRQoL) is poor in patients with persistent diabetic foot ulcers and poor HRQoL predicts worse outcomes in these patients. Amputation is often considered a treatment failure, which is why conservative treatment is generally preferred over amputation. However, it is unclear whether minor amputation negatively affects HRQoL compared with conservative treatment in patients with diabetic foot ulcers. Methods: In the cohort of the multicenter, prospective, observational Eurodiale study, we determined difference in change of HRQoL measured by EQ-5D between patients with a diabetic foot ulcers that healed after conservative treatment (n = 676) and after minor amputation (n = 145). Propensity score was used to adjust for known confounders, attempting to overcome lack of randomization. Results: Baseline HRQoL was not significantly different between patients treated conservatively and undergoing minor amputation. In addition, there was no difference in the change of HRQoL between these groups. In patients who healed 6 to 12 months after the first visit, HRQoL on the anxiety/depression subscale even appeared to improve more in those who underwent minor amputation. Conclusions: Minor amputation was not associated with a negative impact on HRQoL in patients with a diabetic foot ulcers. It may therefore not be considered treatment failure in terms of HRQoL but rather a viable treatment option. A randomized controlled trial is warranted to further examine the influence of minor amputations on health-related quality of life.
|
|
| 15. |
- Qvarford, M., et al.
(author)
-
Polarisation-dependent X-ray absorption in high- and low-Tc Bi2Sr2Can-1CunO4+2n superconductors
- 1993
-
In: Physica C: Superconductivity and its Applications. - : Elsevier BV. - 0921-4534. ; 214:1-2, s. 119-126
-
Journal article (peer-reviewed)abstract
- Taking advantage of the linear polarisation of synchrotron radiation, the polarisation dependence of the O K and Cu L3 X-ray absorption edges has been compared for in situ cleaved Bi2Sr2CaCu2O8 and Bi2Sr2CuO6 single crystals. The X-ray absorption spectra were measured by means of total electron yield detection. The spectra show for both crystals that the lowest unoccupied Cu 3d and O 2p orbitals are dominantly oriented parallel to the a-b plane, but also the presence of a small amount of unoccupied orbitals oriented perpendicular to the a-b plane can be deduced from both the O K and Cu L3 absorption spectra. A shift of the order of 0.5 eV between absorption into the in-plane and the out-of-plane Cu 3d orbitals was measured for the Bi2Sr2CaCu2O8 crystal, but no such shift was found for the Bi2Sr2CuO6 crystal.
|
|
| 16. |
- Ruus, R., et al.
(author)
-
M4,5N4,5N4,5 Auger decay spectra of the resonantly excited 3d94f configuration of xenonlike ions in solids
- 1994
-
In: Physical Review B (Condensed Matter). - 0163-1829. ; 49:21, s. 14836-14844
-
Journal article (peer-reviewed)abstract
- The synchrotron-radiation-induced Auger and photoelectron spectra of the xenonlike ions I- (in CsI), Cs+ (in CsI), Ba2+ (in BaF2), and La3+ (in LaF3) have been measured in the vicinity of the M4,5 absorption edges of these ions. It is shown that the spectra of La and Ba measured at 3d10→3d94f resonances exhibit a very intense 4f-spectator structure which changes its energy and intensity with the energy of the exciting photons. Calculation of the Auger decay of the 3d-14f configuration shows that this structure is due to transitions to the 4d-24f+4p-1 final ionic configuration, the high-energy part of which overlaps the 4d-2 continuum. In the case of Ba this structure coexists with the normal Auger structure which appears as a result of the M4M5N6,7 Coster-Kronig transitions. The spectra of I- contain only the normal M4,5N4,5N4,5 Auger structure related to the 3d-1→4d-2 transitions. The spectra of Cs+ are similar to those of I- with a small admixture of the 4f-spectator-like structure.
|
|
| 17. |
- Sedighi Moghaddam, Maziar, et al.
(author)
-
X-ray computed tomography on chemically modified wood
- 2016
-
Conference paper (peer-reviewed)abstract
- Mapping and visualization of structural changes due to the modification of wood would increase the understanding of chemical modification processes and facilitate optimization of the process parameters. The 2D and 3D microstructure of acetylated and furfurylated softwood and hardwood were visualized using X-ray computed tomography and some anatomical features were investigated such as total porosity, cell wall thickness and maximum opening of tracheid lumens. The wetting properties of chemically modified samples were related to the microstructural properties. Significant changes in the wood structure were observed for furfurylated sapwood samples mainly indicated by a change in tracheid shape and filling of tracheids by furan polymer, whereas no microstructural changes were noted for acetylated samples. Furfurylation significantly decreased the porosity of the sample in both earlywood and latewood regions; whereas for acetylated samples the total porosity of modified and unmodified samples was rather similar. This is in line with results of wetting showing that furfurylation reduced both swelling and capillary uptake in contrast to acetylation which reduced mostly swelling.
|
|
| 18. |
- Sollerbrant, K, et al.
(author)
-
A novel method using baculovirus-mediated gene transfer for production of recombinant adeno-associated virus vectors
- 2001
-
In: The Journal of general virology. - : Microbiology Society. - 0022-1317 .- 1465-2099. ; 82:Pt 9, s. 2051-2060
-
Journal article (peer-reviewed)abstract
- The baculovirus Autographa californica multiple nucleopolyhedrosis virus causes non-productive infection in mammalian cells. Recombinant baculovirus therefore has the capability to transfer and express heterologous genes in these cells if a mammalian promoter governs the gene of interest. We have investigated the possibility of using baculovirus as a tool to produce recombinant adeno-associated virus (rAAV). AAV has become increasingly popular as a vector for gene therapy and functional genomics efforts, although its use is hampered by the lack of a simple and efficient vector production method. We show here that co-infection of mammalian producer cells with three viruses – a baculovirus containing the reporter gene flanked by AAV ITRs, a baculovirus expressing the AAV rep gene and a helper adenovirus expressing the AAV cap gene – produces infectious rAAV particles. This baculovirus-based chimeric vector method may in future improve large-scale rAAV vector preparations and circumvent present-day problems associated with rAAV production.
|
|
| 19. |
- Swietlicki, Erik, et al.
(author)
-
Source identification during the Great Dun Fell Cloud Experiment 1993
- 1997
-
In: Atmospheric Environment. - 1352-2310. ; 31:16, s. 2441-2451
-
Journal article (peer-reviewed)abstract
- A characterisation of the sources influencing the site for the final field campaign of the EUROTRAC subproject GCE (Ground-based Cloud Experiment) at Great Dun Fell, Cumbria, Great Britain in April-May 1993 is presented. The sources were characterised mainly by means of aerosol filter and cascade impactor data, single particle analysis, gas data, data on aromatic organic compounds, cloud water ionic composition, measurements of aerosol size distributions and hygroscopic properties and various meteorological information. Receptor models applied on the aerosol filter and impactor data sets separately revealed two major source types being a marine sea spray source and a long-range transported anthropogenic pollution source. The results of the receptor models were largely consistent with the other observations used in the source identification. Periods of considerable anthropogenic pollution as well as almost pure marine air masses were clearly identified during the course of the experiment.
|
|
| 20. |
|
|
| 21. |
|
|
| 22. |
- Bustin, Stephen A., et al.
(author)
-
The need for transparency and good practices in the qPCR literature
- 2013
-
In: Nature Methods. - : Springer Science and Business Media LLC. - 1548-7091 .- 1548-7105. ; 10:11, s. 1063-1067
-
Journal article (other academic/artistic)abstract
- Two surveys of over 1,700 publications whose authors use quantitative real-time PCR (qPCR) reveal a lack of transparent and comprehensive reporting of essential technical information. Reporting standards are significantly improved in publications that cite the Minimum Information for Publication of Quantitative Real-Time PCR Experiments (MIQE) guidelines, although such publications are still vastly outnumbered by those that do not.
|
|
| 23. |
- Carmeliet, Peter, et al.
(author)
-
Synergism between vascular endothelial growth factor and placental growth factor contributes to angiogenesis and plasma extravasation in pathological conditions
- 2001
-
In: Nature Medicine. - : Springer Science and Business Media LLC. - 1546-170X .- 1078-8956. ; 7:5, s. 575-583
-
Journal article (peer-reviewed)abstract
- Vascular endothelial growth factor (VEGF) stimulates angiogenesis by activating VEGF receptor-2 (VEGFR-2). The role of its homolog, placental growth factor (PlGF), remains unknown. Both VEGF and PlGF bind to VEGF receptor-1 (VEGFR-1), but it is unknown whether VEGFR-1, which exists as a soluble or a membrane-bound type, is an inert decoy or a signaling receptor for PlGF during angiogenesis. Here, we report that embryonic angiogenesis in mice was not affected by deficiency of PlGF (Pgf-/-). VEGF-B, another ligand of VEGFR-1, did not rescue development in Pgf-/- mice. However, loss of PlGF impaired angiogenesis, plasma extravasation and collateral growth during ischemia, inflammation, wound healing and cancer. Transplantation of wild-type bone marrow rescued the impaired angiogenesis and collateral growth in Pgf-/- mice, indicating that PlGF might have contributed to vessel growth in the adult by mobilizing bone-marrow-derived cells. The synergism between PlGF and VEGF was specific, as PlGF deficiency impaired the response to VEGF, but not to bFGF or histamine. VEGFR-1 was activated by PlGF, given that anti-VEGFR-1 antibodies and a Src-kinase inhibitor blocked the endothelial response to PlGF or VEGF/PlGF. By upregulating PlGF and the signaling subtype of VEGFR-1, endothelial cells amplify their responsiveness to VEGF during the 'angiogenic switch' in many pathological disorders.
|
|
| 24. |
|
|
| 25. |
|
|
| 26. |
|
|
| 27. |
- Kokkinou, Efthymia, et al.
(author)
-
The single-cell transcriptional landscape of innate and adaptive lymphocytes in pediatric-onset colitis
- 2023
-
In: Cell reports medicine. - 2666-3791. ; 4:5
-
Journal article (peer-reviewed)abstract
- Innate lymphoid cells (ILCs) are considered innate counterparts of adaptive T cells; however, their common and unique transcriptional signatures in pediatric inflammatory bowel disease (pIBD) are largely unknown. Here, we report a dysregulated colonic ILC composition in pIBD colitis that correlates with inflammatory ac-tivity, including accumulation of naive-like CD45RA+CD62L- ILCs. Weighted gene co-expression network analysis (WGCNA) reveals modules of genes that are shared or unique across innate and adaptive lympho-cytes. Shared modules include genes associated with activation/tissue residency, naivety/quiescence, and antigen presentation. Lastly, nearest-neighbor-based analysis facilitates the identification of most in-flamedand least inflamedlymphocytes in pIBD colon with unique transcriptional signatures. Our study reveals shared and unique transcriptional signatures of colonic ILCs and T cells in pIBD. We also provide insight into the transcriptional regulation of colonic inflammation, deepening our understanding of the poten-tial mechanisms involved in pIBD.
|
|
| 28. |
- Kvedaraite, Egle, et al.
(author)
-
Intestinal stroma guides monocyte differentiation to macrophages through GM-CSF
- 2024
-
In: Nature Communications. - : Springer Nature. - 2041-1723. ; 15:1
-
Journal article (peer-reviewed)abstract
- Stromal cells support epithelial cell and immune cell homeostasis and play an important role in inflammatory bowel disease (IBD) pathogenesis. Here, we quantify the stromal response to inflammation in pediatric IBD and reveal subset-specific inflammatory responses across colon segments and intestinal layers. Using data from a murine dynamic gut injury model and human ex vivo transcriptomic, protein and spatial analyses, we report that PDGFRA+CD142−/low fibroblasts and monocytes/macrophages co-localize in the intestine. In primary human fibroblast-monocyte co-cultures, intestinal PDGFRA+CD142−/low fibroblasts foster monocyte transition to CCR2+CD206+ macrophages through granulocyte-macrophage colony-stimulating factor (GM-CSF). Monocyte-derived CCR2+CD206+ cells from co-cultures have a phenotype similar to intestinal CCR2+CD206+ macrophages from newly diagnosed pediatric IBD patients, with high levels of PD-L1 and low levels of GM-CSF receptor. The study describes subset-specific changes in stromal responses to inflammation and suggests that the intestinal stroma guides intestinal macrophage differentiation.
|
|
| 29. |
- Prompers, L, et al.
(author)
-
Delivery of care to diabetic patients with foot ulcers in daily practice: results of the Eurodiale Study, a prospective cohort study
- 2008
-
In: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 25:6, s. 700-707
-
Journal article (peer-reviewed)abstract
- Aims To determine current management and to identify patient-related factors and barriers that influence management strategies in diabetic foot disease. Methods The Eurodiale Study is a prospective cohort study of 1232 consecutive individuals presenting with a new diabetic foot ulcer in 14 centres across Europe. We determined the use of management strategies: referral, use of offloading, vascular imaging and revascularization. Results Twenty-seven percent of the patients had been treated for > 3 months before referral to a foot clinic. This varied considerably between countries (6-55%). At study entry, 77% of the patients had no or inadequate offloading. During follow-up, casting was used in 35% (0-68%) of the plantar fore- or midfoot ulcers. Predictors of use of casting were male gender, large ulcer size and being employed. Vascular imaging was performed in 56% (14-86%) of patients with severe limb ischaemia; revascularization was performed in 43%. Predictors of use of vascular imaging were the presence of infection and ischaemic rest pain. Conclusion Treatment of many patients is not in line with current guidelines and there are large differences between countries and centres. Our data suggest that current guidelines are too general and that healthcare organizational barriers and personal beliefs result in underuse of recommended therapies. Action should be undertaken to overcome these barriers and to guarantee the delivery of optimal care for the many individuals with diabetic foot disease.
|
|
| 30. |
- Prompers, L., et al.
(author)
-
High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study
- 2007
-
In: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 50:1, s. 18-25
-
Journal article (peer-reviewed)abstract
- Large clinical studies describing the typical clinical presentation of diabetic foot ulcers are limited and most studies were performed in single centres with the possibility of selection of specific subgroups. The aim of this study was to investigate the characteristics of diabetic patients with a foot ulcer in 14 European hospitals in ten countries. The study population included 1,229 consecutive patients presenting with a new foot ulcer between 1 September 2003 and 1 October 2004. Standardised data on patient characteristics, as well as foot and ulcer characteristics, were obtained. Foot disease was categorised into four stages according to the presence or absence of peripheral arterial disease (PAD) and infection: A: PAD -, infection -; B: PAD -, infection +; C: PAD +, infection -; D: PAD +, infection +. PAD was diagnosed in 49% of the subjects, infection in 58%. The majority of ulcers (52%) were located on the non-plantar surface of the foot. With regard to severity, 24% had stage A, 27% had stage B, 18% had stage C and 31% had stage D foot disease. Patients in the latter group had a distinct profile: they were older, had more non-plantar ulcers, greater tissue loss and more serious comorbidity. According to our results in this European cohort, the severity of diabetic foot ulcers at presentation is greater than previously reported, as one-third had both PAD and infection. Non-plantar foot ulcers were more common than plantar ulcers, especially in patients with severe disease, and serious comorbidity increased significantly with increasing severity of foot disease. Further research is needed to obtain insight into the clinical outcome of these patients.
|
|
| 31. |
- Prompers, L., et al.
(author)
-
Prediction of outcome in individuals with diabetic foot ulcers: focus on the differences between individuals with and without peripheral arterial disease. The EURODIALE Study
- 2008
-
In: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 51:5, s. 747-755
-
Journal article (peer-reviewed)abstract
- Aims/hypothesis Outcome data on individuals with diabetic foot ulcers are scarce, especially in those with peripheral arterial disease (PAD). We therefore examined the clinical characteristics that best predict poor outcome in a large population of diabetic foot ulcer patients and examined whether such predictors differ between patients with and without PAD. Methods Analyses were conducted within the EURODIALE Study, a prospective cohort study of 1,088 diabetic foot ulcer patients across 14 centres in Europe. Multiple logistic regression modelling was used to identify independent predictors of outcome (i.e. non-healing of the foot ulcer). Results After 1 year of follow-up, 23% of the patients had not healed. Independent baseline predictors of non-healing in the whole study population were older age, male sex, heart failure, the inability to stand or walk without help, end-stage renal disease, larger ulcer size, peripheral neuropathy and PAD. When analyses were performed according to PAD status, infection emerged as a specific predictor of non-healing in PAD patients only. Conclusions/Interpretation Predictors of healing differ between patients with and without PAD, suggesting that diabetic foot ulcers with or without concomitant PAD should be defined as two separate disease states. The observed negative impact of infection on healing that was confined to patients with PAD needs further investigation.
|
|
| 32. |
|
|
| 33. |
- Siersma, V., et al.
(author)
-
Importance of factors determining the low health-related quality of life in people presenting with a diabetic foot ulcer: the Eurodialestudy
- 2013
-
In: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 30:11, s. 1382-1387
-
Journal article (peer-reviewed)abstract
- AimTo identify the factors responsible for the low health-related quality of life associated with foot ulcers and the relative importance of these factors. MethodsA total of 1232 patients with a new foot ulcer, who presented at one of the 14 centres in 10 European countries participating in the Eurodiale study, were included in this cross-sectional study. Patient and ulcer characteristics were obtained as well as results from the Euro-Qol-5D questionnaire, a health-related quality of life instrument with five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). To analyse the relative importance of comorbidities and ulcer- and patient-related factors for health-related quality of life, linear regression models were used to calculate the relative contributions of each factor to the fit (R-2) of the model. ResultsPatients reported poor overall health-related quality of life, with problems primarily in the mobility and pain/discomfort domains. Among the comorbidities, the inability to stand or walk without help was the most important determinant of decreased health-related quality of life in all five domains. Among ulcer-related factors, ulcer size, limb-threatening ischaemia and elevated C-reactive protein concentration also had high importance in all domains. The clinical diagnosis of infection, peripheral arterial disease and polyneuropathy were only important in the pain/discomfort domain. ConclusionsThe factors that determine health-related quality of life are diverse and to an extent not disease-specific. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important. What's new? The inability to stand or walk without help is the most important determinant of poor health-related quality of life. Other factors with high importance are ulcer size, elevated C-reactive protein concentration and limb-threatening ischaemia. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important.
|
|
| 34. |
|
|
| 35. |
- Snyder, K. J., et al.
(author)
-
Chinese translation of Living on the Edge of Chaos: leading Schools into the Global Age
- 2011
-
Book (peer-reviewed)abstract
- This book is an elegy of education in the industrial civilization and a prelude of educational innovation in an information age. It is written by authors with multi-disciplinary background and years of experiences in educational reform and exploration. The authors explore the shift and innovation of educational paradigms in the 21st century, an age of information and globalization. Guided by the theories and methods of systems science (chaos), this book critically reviews the mechanical view of change, presents some exploratory research and practices with an insight into organization management, and proposes an organic emergent methodology of change. This casts light on school reinvention on the edge of chaos and paves a way for creating global learning centers in the 21st century while unfolding the mission and future of schools as global learning centers. This book is a necessity for 21st century education reformers who want to broaden their horizons and knowledge. It will bring the readers unimaginable wisdom in education innovation. (Text on the back cover) Education pioneers who are dancing with “chains” all have this experience: it is very difficult to reform in the central area of education where traditional forces are strong and powerful, but when they consciously or unconsciously move away from the center to the “chaotic edge”, resistance greatly decreases. The “chaotic edge” is far away from the fierce competition in the “center”, but it is not a barren land without information input. Instead, it is an active area where stagnation and disorder are in frequent change. It is an area where complex systems can adjust and survive and where new ideas and creative practices can grow healthily and rapidly. However, to live on the edge of chaos means to give up all the benefits and profits in the central area and to choose to be marginalized. It also requires the educators to transcend classical view of science, of development, of education, and of methodology, and to get familiar with the epistemology, axiology, and methodology of living on the edge of chaos in complex education systems.
|
|
| 36. |
|
|
| 37. |
|
|
| 38. |
|
|
| 39. |
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
|
|
| 44. |
- van Battum, P., et al.
(author)
-
Differences in minor amputation rate in diabetic foot disease throughout Europe are in part explained by differences in disease severity at presentation
- 2011
-
In: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 28:2, s. 199-205
-
Journal article (peer-reviewed)abstract
- P>Objectives The incidence of minor amputation may vary significantly, and determinants of minor amputation have not been studied systematically. We evaluated minor amputation rate, the determinants of minor amputation and differences in amputation rate between European centres. Methods In the Eurodiale study, a prospective cohort study of 1232 patients (1088 followed until end-point) with a new diabetic foot ulcer were followed on a monthly basis until healing, death, major amputation or up to a maximum of 1 year. Ulcers were treated according to international guidelines. Baseline characteristics independently associated with minor amputation were examined using multiple logistic regression modelling. Based on the results of the multivariable analysis, a disease severity score was calculated for each patient. Results One hundred and ninety-four (18%) patients underwent a minor amputation. Predictors of minor amputation were depth of the ulcer (odds ratio 6.08, confidence interval 4.10-9.03), peripheral arterial disease (odds ratio 1.84, confidence interval 1.30-2.60), infection (odds ratio 1.56, confidence interval 1.05-2.30) and male sex (odds ratio 1.42, confidence interval 0.99-2.04). Minor amputation rate varied between 2.4 and 34% in the centres. Minor amputation rate in centres correlated strongly with disease severity score at the moment of presentation to the foot clinic (r = 0.75). Conclusions Minor amputation is performed frequently in diabetic foot centres throughout Europe and is determined by depth of the ulcer, peripheral arterial disease, infection and male sex. There are important differences in amputation rate between the European centres, which can be explained in part by severity of disease at presentation. This may suggest that early referral to foot clinics can prevent minor amputations.
|
|
