| 1. |
- Ameur, Adam, et al.
(author)
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SweGen : a whole-genome data resource of genetic variability in a cross-section of the Swedish population
- 2017
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In: European Journal of Human Genetics. - : NATURE PUBLISHING GROUP. - 1018-4813 .- 1476-5438. ; 25:11, s. 1253-1260
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Journal article (peer-reviewed)abstract
- Here we describe the SweGen data set, a comprehensive map of genetic variation in the Swedish population. These data represent a basic resource for clinical genetics laboratories as well as for sequencing-based association studies by providing information on genetic variant frequencies in a cohort that is well matched to national patient cohorts. To select samples for this study, we first examined the genetic structure of the Swedish population using high-density SNP-array data from a nation-wide cohort of over 10 000 Swedish-born individuals included in the Swedish Twin Registry. A total of 1000 individuals, reflecting a cross-section of the population and capturing the main genetic structure, were selected for whole-genome sequencing. Analysis pipelines were developed for automated alignment, variant calling and quality control of the sequencing data. This resulted in a genome-wide collection of aggregated variant frequencies in the Swedish population that we have made available to the scientific community through the website https://swefreq.nbis.se. A total of 29.2 million single-nucleotide variants and 3.8 million indels were detected in the 1000 samples, with 9.9 million of these variants not present in current databases. Each sample contributed with an average of 7199 individual-specific variants. In addition, an average of 8645 larger structural variants (SVs) were detected per individual, and we demonstrate that the population frequencies of these SVs can be used for efficient filtering analyses. Finally, our results show that the genetic diversity within Sweden is substantial compared with the diversity among continental European populations, underscoring the relevance of establishing a local reference data set.
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| 2. |
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| 3. |
- Abrahamsson, Johan, et al.
(author)
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On the Efficiency of a Two-Power-Level Flywheel-Based All-Electric Driveline
- 2012
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In: Energies. - : MDPI AG. - 1996-1073. ; 5:8, s. 2794-2817
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Journal article (peer-reviewed)abstract
- This paper presents experimental results on an innovative electric driveline employing a kinetic energy storage device as energy buffer. A conceptual division of losses in the system was created, separating the complete system into three parts according to their function. This conceptualization of the system yielded a meaningful definition of the concept of efficiency. Additionally, a thorough theoretical framework for the prediction of losses associated with energy storage and transfer in the system was developed. A large number of spin-down tests at varying pressure levels were performed. A separation of the measured data into the different physical processes responsible for power loss was achieved from the corresponding dependence on rotational velocity. This comparison yielded an estimate of the perpendicular resistivity of the stranded copper conductor of 2.5 x 10(-8) +/- 3.5 x 10(-9). Further, power and energy were measured system-wide during operation, and an analysis of the losses was performed. The analytical solution was able to reproduce the measured distribution of losses in the system to an accuracy of 4.7% (95% CI). It was found that the losses attributed to the function of kinetic energy storage in the system amounted to between 45% and 65%, depending on usage.
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| 4. |
- Abrahamsson, Johan, et al.
(author)
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Prototype of electric driveline with magnetically levitated double wound motor
- 2010
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In: Electrical Machines (ICEM), 2010 XIX International Conference on.
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Conference paper (peer-reviewed)abstract
- This paper presents the ongoing work of constructing a complete driveline for an electric road vehicle, using a flywheel as auxiliary energy storage. The flywheel energy storage system (FESS) is connected in series between the main energy storage (batteries) and the wheel motor of the vehicle, allowing the batteries to deliver power to the system in an optimized way, while at the same time making efficient use of regenerative braking. A double wound permanent magnet electric machine is used to electrically separate the two sides. In order to minimize losses, the machine has a double rotor configuration and is suspended with magnetic bearings. A bench test set-up is being constructed to investigate the properties of this system in detail. This set-up will achieve a level of power and energy close to that of a full scale system. This will allow measurements of complete drive cycles to be performed, improving the understanding of the constituting components and optimization of the complete system.
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| 5. |
- Askander, Mikael, et al.
(author)
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Lady Gaga : scenerna, medierna, fansen
- 2014
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In: Coda: en andra antologi om musik och samhälle.
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Book chapter (peer-reviewed)abstract
- This is a mapping of my upcoming project on the field of short culture phenomena. One part of that will deal with the music videos of Lady Gaga. In this book chapter I present som basic information on Lady Gaga, and suggestions on how to approach the artist and her artistic/aesthetic expressions. Scenes, stage performance, media, and the different relation to the fans is put into focus, and I mean that one must both take all these aspects into account, and deal with them as combined/integrated parts of thw whole, when trying to understand Lady Gagas world of ideas.
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| 6. |
- Boissin, Constance, et al.
(author)
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Development and evaluation of deep learning algorithms for assessment of acute burns and the need for surgery
- 2023
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In: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1
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Journal article (peer-reviewed)abstract
- Assessment of burn extent and depth are critical and require very specialized diagnosis. Automated image-based algorithms could assist in performing wound detection and classification. We aimed to develop two deep-learning algorithms that respectively identify burns, and classify whether they require surgery. An additional aim assessed the performances in different Fitzpatrick skin types. Annotated burn (n = 1105) and background (n = 536) images were collected. Using a commercially available platform for deep learning algorithms, two models were trained and validated on 70% of the images and tested on the remaining 30%. Accuracy was measured for each image using the percentage of wound area correctly identified and F1 scores for the wound identifier; and area under the receiver operating characteristic (AUC) curve, sensitivity, and specificity for the wound classifier. The wound identifier algorithm detected an average of 87.2% of the wound areas accurately in the test set. For the wound classifier algorithm, the AUC was 0.885. The wound identifier algorithm was more accurate in patients with darker skin types; the wound classifier was more accurate in patients with lighter skin types. To conclude, image-based algorithms can support the assessment of acute burns with relatively good accuracy although larger and different datasets are needed.
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| 7. |
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| 8. |
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| 9. |
- de Santiago Ochoa, Juan, et al.
(author)
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Design Parameters Calculation of a Novel Driveline for Electric Vehicles
- 2009
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In: World Electric Vehicle Journal. - 2032-6653. ; 3
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Journal article (peer-reviewed)abstract
- A driveline for electric vehicles is presented. The propulsion system is operated at a higher voltage than the primary energy source. The batteries selected as the primary energy source deliver power to the vehicle through a motor-generator wounded with two electrically isolated sets of windings, named Two Voltage Level Machine (TVLM). The dynamic behaviour of a vehicle operating according to a standard drive cycle is studied. Parameters of the driveline such as power rates and size of the flywheel are obtained by optimization. A description of the performance of a TVLM is also presented through its equivalent circuit and the control of the machine. Special attention to the system losses is presented. A scale prototype has been constructed and tested under a drive cycle, demonstrating the system performance of the system.
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| 10. |
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| 11. |
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| 12. |
- Hedlund, Magnus, 1986-, et al.
(author)
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Eddy Currents in a Passive Magnetic Axial Thrust Bearing for a Flywheel Energy Storage System
- 2017
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In: International journal of applied electromagnetics and mechanics. - 1383-5416 .- 1875-8800. ; 54:3, s. 389-404
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Journal article (peer-reviewed)abstract
- Two types of passive magnetic lift bearings were evaluated in terms of thrust force and eddy current losses. The first type of bearings were based on two sets of segmented Halbach arrays mounted in repulsive mode, and the second type was based on ring-magnets. The eddy-currents studied arose in the bearing due to manufacturing variations of magnetic remanence, and due to non-radial magnetization. Both a 3D time-dependent and a quasi-stationary Finite-Element Method (FEM) formulation were used, and the simulated results were compared with lift-force measurements from experiment. The losses were found (by FEM) to be in the order of 25 W at a rotational speed of 30000 rpm while lifting a 45 kg rotor with a stiffness of 359 N/mm.
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| 13. |
- Hedlund, Magnus, 1986-, et al.
(author)
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Flywheel Energy Storage for Automotive Applications
- 2015
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In: Energies. - : MDPI AG. - 1996-1073. ; 8:10, s. 10636-10663
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Research review (peer-reviewed)abstract
- A review of flywheel energy storage technology was made, with a special focus on the progress in automotive applications. We found that there are at least 26 university research groups and 27 companies contributing to flywheel technology development. Flywheels are seen to excel in high-power applications, placing them closer in functionality to supercapacitors than to batteries. Examples of flywheels optimized for vehicular applications were found with a specific power of 5.5 kW/kg and a specific energy of 3.5 Wh/kg. Another flywheel system had 3.15 kW/kg and 6.4 Wh/kg, which can be compared to a state-of-the-art supercapacitor vehicular system with 1.7 kW/kg and 2.3 Wh/kg, respectively. Flywheel energy storage is reaching maturity, with 500 flywheel power buffer systems being deployed for London buses (resulting in fuel savings of over 20%), 400 flywheels in operation for grid frequency regulation and many hundreds more installed for uninterruptible power supply (UPS) applications. The industry estimates the mass-production cost of a specific consumer-car flywheel system to be 2000 USD. For regular cars, this system has been shown to save 35% fuel in the U.S. Federal Test Procedure (FTP) drive cycle.
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| 14. |
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| 15. |
- Hilborn, Emma, et al.
(author)
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Mot ljuset : En antologi om arbete, arbetare och arbetarrörelse
- 2019
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In: Mot ljuset : En antologi om arbete, arbetare och arbetarrörelse - En antologi om arbete, arbetare och arbetarrörelse. - Landskrona : Centrum för arbetarhistoria. - 9789197966153 ; , s. 5-7
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Book chapter (other academic/artistic)
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| 16. |
- Holmstrom, Oscar, et al.
(author)
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Detection of breast cancer lymph node metastases in frozen sections with a point-of care low-cost microscope scanner
- 2019
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:3
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Journal article (peer-reviewed)abstract
- Background Detection of lymph node metastases is essential in breast cancer diagnostics and staging, affecting treatment and prognosis. lntraoperative microscopy analysis of sentinel lymph node frozen sections is standard for detection of axillary metastases but requires access to a pathologist for sample analysis. Remote analysis of digitized samples is an alternative solution but is limited by the requirement for high-end slide scanning equipment.Objective To determine whether the image quality achievable with a low-cost, miniature digital microscope scanner is sufficient for detection of metastases in breast cancer lymph node frozen sections.Methods Lymph node frozen sections from 79 breast cancer patients were digitized using a prototype miniature microscope scanner and a high-end slide scanner. Images were independently reviewed by two pathologists and results compared between devices with conventional light microscopy analysis as ground truth.Results Detection of metastases in the images acquired with the miniature scanner yielded an overall sensitivity of 91% and specificity of 99% and showed strong agreement when compared to light microscopy (k = 0.91). Strong agreement was also observed when results were compared to results from the high-end slide scanner (k = 0.94). A majority of discrepant cases were micrometastases and sections of which no anticytokeratin staining was available.ConclusionAccuracy of detection of metastatic cells in breast cancer sentinel lymph node frozen sections by visual analysis of samples digitized using low-cost, point-of-care microscopy is comparable to analysis of digital samples scanned using a high-end, whole slide scanner. This technique could potentially provide a workflow for digital diagnostics in resource-limited settings, facilitate sample analysis at the point-of-care and reduce the need for trained experts on-site during surgical procedures.
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| 17. |
- Holmström, Oscar, et al.
(author)
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A novel deep learning-based point-of-care diagnostic method for detecting Plasmodium falciparum with fluorescence digital microscopy.
- 2020
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:11
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Journal article (peer-reviewed)abstract
- BACKGROUND: Malaria remains a major global health problem with a need for improved field-usable diagnostic tests. We have developed a portable, low-cost digital microscope scanner, capable of both brightfield and fluorescence imaging. Here, we used the instrument to digitize blood smears, and applied deep learning (DL) algorithms to detect Plasmodium falciparum parasites.METHODS: Thin blood smears (n = 125) were collected from patients with microscopy-confirmed P. falciparum infections in rural Tanzania, prior to and after initiation of artemisinin-based combination therapy. The samples were stained using the 4',6-diamidino-2-phenylindole fluorogen and digitized using the prototype microscope scanner. Two DL algorithms were trained to detect malaria parasites in the samples, and results compared to the visual assessment of both the digitized samples, and the Giemsa-stained thick smears.RESULTS: Detection of P. falciparum parasites in the digitized thin blood smears was possible both by visual assessment and by DL-based analysis with a strong correlation in results (r = 0.99, p < 0.01). A moderately strong correlation was observed between the DL-based thin smear analysis and the visual thick smear-analysis (r = 0.74, p < 0.01). Low levels of parasites were detected by DL-based analysis on day three following treatment initiation, but a small number of fluorescent signals were detected also in microscopy-negative samples.CONCLUSION: Quantification of P. falciparum parasites in DAPI-stained thin smears is feasible using DL-supported, point-of-care digital microscopy, with a high correlation to visual assessment of samples. Fluorescent signals from artefacts in samples with low infection levels represented the main challenge for the digital analysis, thus highlighting the importance of minimizing sample contaminations. The proposed method could support malaria diagnostics and monitoring of treatment response through automated quantification of parasitaemia and is likely to be applicable also for diagnostics of other Plasmodium species and other infectious diseases.
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| 18. |
- Holmström, Oscar, et al.
(author)
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Point-of-Care Digital Cytology With Artificial Intelligence for Cervical Cancer Screening in a Resource-Limited Setting
- 2021
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In: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 4:3
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Journal article (peer-reviewed)abstract
- Importance: Cervical cancer is highly preventable but remains a common and deadly cancer in areas without screening programs. The creation of a diagnostic system to digitize Papanicolaou test samples and analyze them using a cloud-based deep learning system (DLS) may provide needed cervical cancer screening to resource-limited areas.Objective: To determine whether artificial intelligence-supported digital microscopy diagnostics can be implemented in a resource-limited setting and used for analysis of Papanicolaou tests.Design, Setting, and Participants: In this diagnostic study, cervical smears from 740 HIV-positive women aged between 18 and 64 years were collected between September 1, 2018, and September 30, 2019. The smears were digitized with a portable slide scanner, uploaded to a cloud server using mobile networks, and used to train and validate a DLS for the detection of atypical cervical cells. This single-center study was conducted at a local health care center in rural Kenya.Exposures: Detection of squamous cell atypia in the digital samples by analysis with the DLS.Main Outcomes and Measures: The accuracy of the DLS in the detection of low- and high-grade squamous intraepithelial lesions in Papanicolaou test whole-slide images.Results: Papanicolaou test results from 740 HIV-positive women (mean [SD] age, 41.8 [10.3] years) were collected. The DLS was trained using 350 whole-slide images and validated on 361 whole-slide images (average size, 100 387 x 47 560 pixels). For detection of cervical cellular atypia, sensitivities were 95.7% (95% CI, 85.5%-99.5%) and 100% (95% CI, 82.4%-100%), and specificities were 84.7% (95% CI, 80.2%-88.5%) and 78.4% (95% CI, 73.6%-82.4%), compared with the pathologist assessment of digital and physical slides, respectively. Areas under the receiver operating characteristic curve were 0.94 and 0.96, respectively. Negative predictive values were high (99%-100%), and accuracy was high, particularly for the detection of high-grade lesions. Interrater agreement was substantial compared with the pathologist assessment of digital slides (kappa = 0.72) and fair compared with the assessment of glass slides (kappa = 0.36). No samples that were classified as high grade by manual sample analysis had false-negative assessments by the DLS.Conclusions and Relevance: In this study, digital microscopy with artificial intelligence was implemented at a rural clinic and used to detect atypical cervical smears with a high sensitivity compared with visual sample analysis.
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| 19. |
- Holmström, Oscar, et al.
(author)
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Point-of-care mobile digital microscopy and deep learning for the detection of soil-transmitted helminths and Schistosoma haematobium
- 2017
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In: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:sup3
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Journal article (peer-reviewed)abstract
- BACKGROUND: Microscopy remains the gold standard in the diagnosis of neglected tropical diseases. As resource limited, rural areas often lack laboratory equipment and trained personnel, new diagnostic techniques are needed. Low-cost, point-of-care imaging devices show potential in the diagnosis of these diseases. Novel, digital image analysis algorithms can be utilized to automate sample analysis.OBJECTIVE: Evaluation of the imaging performance of a miniature digital microscopy scanner for the diagnosis of soil-transmitted helminths and Schistosoma haematobium, and training of a deep learning-based image analysis algorithm for automated detection of soil-transmitted helminths in the captured images.METHODS: A total of 13 iodine-stained stool samples containing Ascaris lumbricoides, Trichuris trichiura and hookworm eggs and 4 urine samples containing Schistosoma haematobium were digitized using a reference whole slide-scanner and the mobile microscopy scanner. Parasites in the images were identified by visual examination and by analysis with a deep learning-based image analysis algorithm in the stool samples. Results were compared between the digital and visual analysis of the images showing helminth eggs.RESULTS: Parasite identification by visual analysis of digital slides captured with the mobile microscope was feasible for all analyzed parasites. Although the spatial resolution of the reference slide-scanner is higher, the resolution of the mobile microscope is sufficient for reliable identification and classification of all parasites studied. Digital image analysis of stool sample images captured with the mobile microscope showed high sensitivity for detection of all helminths studied (range of sensitivity = 83.3-100%) in the test set (n = 217) of manually labeled helminth eggs.CONCLUSIONS: In this proof-of-concept study, the imaging performance of a mobile, digital microscope was sufficient for visual detection of soil-transmitted helminths and Schistosoma haematobium. Furthermore, we show that deep learning-based image analysis can be utilized for the automated detection and classification of helminths in the captured images.
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| 20. |
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| 21. |
- Johan, Lundin, et al.
(author)
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Hiphop som väg till socialt kapital och lärande
- 2014
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In: Coda Andra antologin om musik och samhälle. Johan A. Lundin, Johan Söderman och Mikael Askander (red.). - Malmö : Kira förlag. - 9789198092196
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Book chapter (other academic/artistic)
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| 22. |
- Khalili, Payam, 1977-, et al.
(author)
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Combined effects of brachial pulse pressure and sialic acid for risk of cardiovascular events during 40 years of follow-up in 37 843 individuals
- 2012
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In: Journal of Hypertension. - Philadelphia, USA : Lippincott Williams & Wilkins. - 0263-6352 .- 1473-5598. ; 30:9, s. 1718-1724
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Journal article (peer-reviewed)abstract
- Objective: Pulse pressure (PP) is a risk marker for cardiovascular disease (CVD) in individuals 50 years and older. Inflammation is suggested to influence atherosclerosis, but could also increase PP. We aimed to examine the combined effects of PP and the inflammatory marker sialic acid, and their independent roles on CVD risk. Methods: From a population-based study in Sweden between 1962 and 1965, 18 429 men and 19 414 women at the age of 50 or older were selected and followed for first CVD event until 2005. We investigated the biological interactions between sialic acid and PP. The associations of PP and sialic acid with risk of CVD were calculated by using Cox proportional hazards model. Adjustments were made for conventional risk factors, mean arterial pressure (MAP) and socioeconomic status. Results: The mean age was 59.5 (SD 6.5) years and the number of incident CVD events in men and women were 3641 and 3227, respectively. No biological interaction was seen between PP and sialic acid. In men, the adjusted hazard ratio for PP was 0.92 [95% confidence interval (CI) 0.88-0.96, P < 0.0001) for 1 SD of PP, and 1.09 (95% CI 1.05-1.13, P < 0.0001) for 1 SD of sialic acid. In women, the corresponding figures were 1.02 (95% CI 0.97-1.07, P = 0.48) and 1.09 (95% CI 1.05-1.13, P < 0.0001). Conclusions: Sialic acid but not PP was an independent risk factor for CVD. The risk induced by PP is highly affected by MAP. This suggests that both estimated arterial stiffness and inflammation contribute through different pathways to risk of CVD.
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| 23. |
- Khalili, Payam, 1977-, et al.
(author)
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Sialic acid and incidence of hospitalization for diabetes and its complications during 40-years of follow-up in a large cohort : The Värmland survey
- 2014
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In: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 8:4, s. 352-357
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Journal article (peer-reviewed)abstract
- Aim: To examine the association of sialic acid (SA) with first recorded diabetes mellitus-related hospitalization.Methods: From a population-based study in Varmland, Sweden, between 1962 and 1965, 87,035 men and women were selected and followed for first recorded diabetes-related hospitalization until 2005. The association of SA was calculated and stratified for gender by Cox's proportional hazards models. Adjustments were made for conventional risk factors and socioeconomic status. Association analyses were made for comparisons between SA-levels above and below median.Results: The mean age was 47.2 (SD 13.0) years and the total numbers of incident diabetes-related hospitalizations in men and women were 3445 and 3273, respectively. Hazard ratios per one standard deviation of SA were 1.12 (95% CI: 1.08-1.17, p < 0.0001) in men and 1.17 (95% CI: 1.13-1.22, p < 0.0001) in women. Interaction analyses indicated a relatively higher SA-associated risk in women than in men with above median SA levels.Conclusions: In this large population-based cohort followed for more than 40 years, elevated SA, as a marker of systemic inflammation, was independently associated with risk of diabetes and diabetes-related hospitalizations. (C) 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.
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| 24. |
- Linder, Nina, et al.
(author)
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Deep learning for detecting tumour-infiltrating lymphocytes in testicular germ cell tumours
- 2019
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In: Journal of Clinical Pathology. - : BMJ Publishing Group Ltd. - 0021-9746 .- 1472-4146. ; 72:2, s. 157-164
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Journal article (peer-reviewed)abstract
- AIMS: To evaluate if a deep learning algorithm can be trained to identify tumour-infiltrating lymphocytes (TILs) in tissue samples of testicular germ cell tumours and to assess whether the TIL counts correlate with relapse status of the patient.METHODS: TILs were manually annotated in 259 tumour regions from 28 whole-slide images (WSIs) of H&E-stained tissue samples. A deep learning algorithm was trained on half of the regions and tested on the other half. The algorithm was further applied to larger areas of tumour WSIs from 89 patients and correlated with clinicopathological data.RESULTS: A correlation coefficient of 0.89 was achieved when comparing the algorithm with the manual TIL count in the test set of images in which TILs were present (n=47). In the WSI regions from the 89 patient samples, the median TIL density was 1009/mm2. In seminomas, none of the relapsed patients belonged to the highest TIL density tertile (>2011/mm2). TIL quantifications performed visually by three pathologists on the same tumours were not significantly associated with outcome. The average interobserver agreement between the pathologists when assigning a patient into TIL tertiles was 0.32 (Kappa test) compared with 0.35 between the algorithm and the experts, respectively. A higher TIL density was associated with a lower clinical tumour stage, seminoma histology and lack of lymphovascular invasion.CONCLUSIONS: Deep learning-based image analysis can be used for detecting TILs in testicular germ cell cancer more objectively and it has potential for use as a prognostic marker for disease relapse.
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| 25. |
- Lundin, Andreas, et al.
(author)
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Drug therapy in cardiac arrest : a review of the literature
- 2016
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In: European heart journal. Cardiovascular pharmacotherapy. - : Oxford University Press (OUP). - 2055-6845 .- 2055-6837. ; 2:1, s. 54-75
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Journal article (peer-reviewed)abstract
- The aim of this study was to review the literature on human studies of drug therapy in cardiac arrest during the last 25 years. In May 2015, a systematic literature search was performed in PubMed, Embase, the Cochrane Library, and CRD databases. Prospective interventional and observational studies evaluating a specified drug therapy in human cardiac arrest reporting a clinical endpoint [i.e. return of spontaneous circulation (ROSC) or survival] and published in English 1990 or later were included, whereas animal studies, case series and reports, studies of drug administration, drug pharmacology, non-specified drug therapies, preventive drug therapy, drug administration after ROSC, studies with primarily physiological endpoints, and studies of traumatic cardiac arrest were excluded. The literature search identified a total of 8936 articles. Eighty-eight articles met our inclusion criteria and were included in the review. We identified no human study in which drug therapy, compared with placebo, improved long-term survival. Regarding adrenaline and amiodarone, the drugs currently recommended in cardiac arrest, two prospective randomized placebo-controlled trials, were identified for adrenaline, and one for amiodarone, but they were all underpowered to detect differences in survival to hospital discharge. Of all reviewed studies, only one recent prospective study demonstrated improved neurological outcome with one therapy over another using a combination of vasopressin, steroids, and adrenaline as the intervention compared with standard adrenaline administration. The evidence base for drug therapy in cardiac arrest is scarce. However, many human studies on drug therapy in cardiac arrest have not been powered to identify differences in important clinical outcomes such as survival to hospital discharge and favourable neurological outcome. Efforts are needed to initiate large multicentre prospective randomized clinical trials to evaluate both currently recommended and future drug therapies.
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| 26. |
- Lundin, Erik, 1970-, et al.
(author)
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Radiotherapy as Elective Treatment of the Node-negative Neck in Oral Squamous Cell Cancer
- 2021
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In: Anticancer Research. - : International Institute of Anticancer Research. - 0250-7005 .- 1791-7530. ; 41:7, s. 3489-3498
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Journal article (peer-reviewed)abstract
- BACKGROUND/AIM: Previous studies of node-negative oral squamous cell carcinoma have shown a benefit of elective neck dissection compared to observation. Evidence for radiotherapy as single-modality elective treatment of the node-negative neck is so far lacking.PATIENTS AND METHODS: In a retrospective material of 420 early-stage oral cancers from 2000 to 2016, overall survival, disease-free survival, and regional relapse-free survival were calculated with the Kaplan-Meier method.RESULTS: At five years, overall survival was 59.7%, disease-specific survival was 77.2%, and regional relapse-free survival was 83.5%. Among those with adjuvant treatment of the neck after surgery of T1-T2 tumours during 2009-2016, regional relapse-free survival at five years was 85.7% for elective radiotherapy of the neck and 87.4% for elective neck dissection.CONCLUSION: Elective radiotherapy to the neck with a modern technique and adequate dose might be an alternative to neck dissection for patients with early-stage oral squamous cell cancer.
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| 27. |
- Lundin, Erik, 1970-, et al.
(author)
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Validation of a Clinical Cancer Register at the Head and Neck Oncology Center in Orebro
- 2019
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In: Anticancer Research. - : International Institute of Anticancer Research. - 0250-7005 .- 1791-7530. ; 39:1, s. 285-289
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Journal article (peer-reviewed)abstract
- Background: This was a validation study of a regional register of oral cancer in Örebro, Sweden. The purpose was to assess the rate of errors in baseline, and treatment, and the completeness and accuracy of data on recurrences.Materials and Methods: A total of 653 cases with squamous cell cancer in the oral cavity were identified from the register. A randomized sample of 73 (11%) was selected, and a set of relevant data was compared to medical records.Results: Data on patient and tumour characteristics showed high accuracy, with 98% correct data and more than 99% of treatment data were correct. Follow-up data had a higher rate of errors, with 23% of recurrences not recorded, 13.6% misclassified, and 9.1% of cases showing errors in timing of the recurrence.Conclusion: data concerning patients, tumour status, and treatment in the Regional Head and Neck Register in Örebro are highly accurate. However, the follow-up data contain a higher rate of errors, that must be taken into consideration when evaluating outcome after treatment.
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| 28. |
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| 29. |
- Lundin, Johan, et al.
(author)
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Diagnosis of soil-transmitted helminth infections with digital mobile microscopy and artificial intelligence in a resource-limited setting
- 2024
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In: PLoS Neglected Tropical Diseases. - : Public Library of Science (PLoS). - 1935-2727 .- 1935-2735. ; 18:4
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Journal article (peer-reviewed)abstract
- Background: Infections caused by soil-transmitted helminths (STHs) are the most prevalent neglected tropical diseases and result in a major disease burden in low- and middle-income countries, especially in school-aged children. Improved diagnostic methods, especially for light intensity infections, are needed for efficient, control and elimination of STHs as a public health problem, as well as STH management. Image-based artificial intelligence (AI) has shown promise for STH detection in digitized stool samples. However, the diagnostic accuracy of AI-based analysis of entire microscope slides, so called whole-slide images (WSI), has previously not been evaluated on a sample-level in primary healthcare settings in STH endemic countries.Methodology/Principal findings: Stool samples (n = 1,335) were collected during 2020 from children attending primary schools in Kwale County, Kenya, prepared according to the Kato-Katz method at a local primary healthcare laboratory and digitized with a portable whole-slide microscopy scanner and uploaded via mobile networks to a cloud environment. The digital samples of adequate quality (n = 1,180) were split into a training (n = 388) and test set (n = 792) and a deep-learning system (DLS) developed for detection of STHs. The DLS findings were compared with expert manual microscopy and additional visual assessment of the digital samples in slides with discordant results between the methods. Manual microscopy detected 15 (1.9%) Ascaris lumbricoides, 172 (21.7%) Tricuris trichiura and 140 (17.7%) hookworm (Ancylostoma duodenale or Necator americanus) infections in the test set. Importantly, more than 90% of all STH positive cases represented light intensity infections. With manual microscopy as the reference standard, the sensitivity of the DLS as the index test for detection of A. lumbricoides, T. trichiura and hookworm was 80%, 92% and 76%, respectively. The corresponding specificity was 98%, 90% and 95%. Notably, in 79 samples (10%) classified as negative by manual microscopy for a specific species, STH eggs were detected by the DLS and confirmed correct by visual inspection of the digital samples.Conclusions/Significance: Analysis of digitally scanned stool samples with the DLS provided high diagnostic accuracy for detection of STHs. Importantly, a substantial number of light intensity infections were missed by manual microscopy but detected by the DLS. Thus, analysis of WSIs with image-based AI may provide a future tool for improved detection of STHs in a primary healthcare setting, which in turn could facilitate monitoring and evaluation of control programs.
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| 30. |
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| 31. |
- Lundin, Johan, et al.
(author)
-
Learning in logistics and operations management using computer based simulation
- 2008
-
In: [Host publication title missing].
-
Conference paper (peer-reviewed)abstract
- In this study we investigate to what extent computer based discrete event simulation modeling can contribute to students’ learning processes in logistics and production management courses. Our interest in simulation stems from the fact that it is not possible to let students experiment with real logistics and production systems. This is an issue because the complexity and stochastic nature of these systems are inherently difficult to grasp. A potential remedy is to use a discrete event simulation software to create a computer model that can illustrate the dynamics of the system, and allow for experimentation. In our approach we define the learning process in accordance with Kolb’s model for experimental learning. We then use a survey on two different student groups to investigate how they perceive that simulation affects their learning process. Group 1 (students in a logistics course on G2 level) had no prior knowledge of the simulation tool. Group 2 (students in a production management course on Advanced level) had taken at least one course in simulation before. The results indicate that both student groups perceive simulation as a good tool to enhance their learning experience, but Group 2 (with the more senior and experienced students) valued the use of simulation more.
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| 32. |
- Lundin, Mona, 1976, et al.
(author)
-
Learning the discourse of quality assurance: a case of workplace learning in online in-service training.
- 2016
-
In: Journal of Workplace Learning. - 1366-5626. ; 28:3, s. 98-114
-
Journal article (peer-reviewed)abstract
- Purpose – In this study, online in-service training for people employed in the food production industry is scrutinized. The purpose of this study is to analyse how the participants adapt to such online environments in terms of the kind of discussions they establish. The more specific interest relates to how the participants discuss current work experiences in relation to the contents of quality assurance they are expected to learn. Design/methodology/approach – The data analyzed are Web discussions in forms of chat log files from ten courses. Findings – The results show that, on the one hand, general principles have to be substantiated in the form of concrete examples to actually function as principles and, on the other hand, concrete examples are made interesting only if they have a bearing on a more general issue. Another interesting finding is that the course participants gradually take over the vocabulary of quality assurance; they more frequently write about their work in terms of, e.g. criteria, relevance, estimations and hazards. The conclusion is that Web discussions as part of in-service training constitute a new arena for reflection in and on practice. Originality/value – This is interesting to explore, as it is designed to meet the needs of employers and employees to learn the new set of rules and procedures, which regulate the European food industry. In this respect, the training activities are of direct relevance to daily work practices. Simultaneously, online environments seem to offer flexibility and thus constitute a solution for training in a dispersed industry
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| 33. |
- Robba, Chiara, et al.
(author)
-
Oxygen targets and 6-month outcome after out of hospital cardiac arrest : a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial
- 2022
-
In: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26, s. 1-13
-
Journal article (peer-reviewed)abstract
- Background: Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO2) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO2 with patients’ outcome. Methods: Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO2 < 60 mmHg and severe hyperoxemia as PaO2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results: 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO2-AUC), for hyperoxemia was significantly associated with mortality (p = 0.003). Conclusions: In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration: clinicaltrials.gov NCT02908308, Registered September 20, 2016.
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| 34. |
- Selander, Sven-Åke, et al.
(author)
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Koral och kultur i svensk tradition
- 2014
-
In: Coda : andra antologin om musik och samhälle - andra antologin om musik och samhälle. - 9789198092196 ; 2, s. 113-123
-
Book chapter (other academic/artistic)
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| 35. |
- Stenman, Sebastian, et al.
(author)
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A deep learning-based algorithm for tall cell detection in papillary thyroid carcinoma
- 2022
-
In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:8
-
Journal article (peer-reviewed)abstract
- Introduction:According to the World Health Organization, the tall cell variant (TCV) is an aggressive subtype of papillary thyroid carcinoma (PTC) comprising at least 30% epithelial cells two to three times as tall as they are wide. In practice, applying this definition is difficult causing substantial interobserver variability. We aimed to train a deep learning algorithm to detect and quantify the proportion of tall cells (TCs) in PTC.Methods: We trained the deep learning algorithm using supervised learning, testing it on an independent dataset, and further validating it on an independent set of 90 PTC samples from patients treated at the Hospital District of Helsinki and Uusimaa between 2003 and 2013. We compared the algorithm-based TC percentage to the independent scoring by a human investigator and how those scorings associated with disease outcomes. Additionally, we assessed the TC score in 71 local and distant tumor relapse samples from patients with aggressive disease.Results: In the test set, the deep learning algorithm detected TCs with a sensitivity of 93.7% and a specificity of 94.5%, whereas the sensitivity fell to 90.9% and specificity to 94.1% for non-TC areas. In the validation set, the deep learning algorithm TC scores correlated with a diminished relapse-free survival using cutoff points of 10% (p = 0.044), 20% (p < 0.01), and 30% (p = 0.036). The visually assessed TC score did not statistically significantly predict survival at any of the analyzed cutoff points. We observed no statistically significant difference in the TC score between primary tumors and relapse tumors determined by the deep learning algorithm or visually.Conclusions: We present a novel deep learning-based algorithm to detect tall cells, showing that a high deep learning-based TC score represents a statistically significant predictor of less favorable relapse-free survival in PTC.
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| 36. |
- Sävblom, C, et al.
(author)
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Association between polymorphisms in the prostate-specific antigen (PSA) promoter and release of PSA
- 2009
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In: International Journal of Andrology. - : Wiley-Blackwell. - 0105-6263 .- 1365-2605. ; 32:5, s. 479-485
-
Journal article (peer-reviewed)abstract
- Variations in serum prostate-specific antigen (PSA) have been ascribed to A/G nucleotide polymorphisms located at -158 bp (rs266882) and -4643 bp (rs925013), relative to the transcription start site within the promoter of the PSA gene. PSA is also an androgen receptor target (AR) gene and polymorphisms in AR gene are known to affect AR function. Our objective was to compare the impact of these A/G polymorphisms separately or in combination with AR CAG micro satellite on regulation of PSA secretion into seminal plasma and blood in young men. Leukocyte DNA was extracted from 291 conscripts and genotyping performed with the Sequenom Mass Array System. PSA was measured with an immunofluorometric assay. Linear regression analysis was used to test the association of polymorphism frequencies with serum and seminal plasma levels of PSA. PSA gene polymorphisms at -158 bp or -4643 bp did not alone influence total PSA (tPSA) levels in seminal plasma or in blood. Homozygotes for the A-allele at -158 bp in combination with CAG > 22 had significantly higher serum levels of tPSA than subjects carrying the G-allele (p = 0.01). In conclusion, the PSA gene polymorphisms did not importantly influence the levels of tPSA in seminal plasma or in blood. tPSA in serum was influenced by interactions between PSA promoter variants and AR CAG polymorphism.
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| 37. |
- Turkki, Riku, et al.
(author)
-
Breast cancer outcome prediction with tumour tissue images and machine learning
- 2019
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In: Breast Cancer Research and Treatment. - : SPRINGER. - 0167-6806 .- 1573-7217. ; 177:1, s. 41-52
-
Journal article (peer-reviewed)abstract
- Purpose: Recent advances in machine learning have enabled better understanding of large and complex visual data. Here, we aim to investigate patient outcome prediction with a machine learning method using only an image of tumour sample as an input.Methods: Utilising tissue microarray (TMA) samples obtained from the primary tumour of patients (N=1299) within a nationwide breast cancer series with long-term-follow-up, we train and validate a machine learning method for patient outcome prediction. The prediction is performed by classifying samples into low or high digital risk score (DRS) groups. The outcome classifier is trained using sample images of 868 patients and evaluated and compared with human expert classification in a test set of 431 patients.Results: In univariate survival analysis, the DRS classification resulted in a hazard ratio of 2.10 (95% CI 1.33-3.32, p=0.001) for breast cancer-specific survival. The DRS classification remained as an independent predictor of breast cancer-specific survival in a multivariate Cox model with a hazard ratio of 2.04 (95% CI 1.20-3.44, p=0.007). The accuracy (C-index) of the DRS grouping was 0.60 (95% CI 0.55-0.65), as compared to 0.58 (95% CI 0.53-0.63) for human expert predictions based on the same TMA samples.Conclusions: Our findings demonstrate the feasibility of learning prognostic signals in tumour tissue images without domain knowledge. Although further validation is needed, our study suggests that machine learning algorithms can extract prognostically relevant information from tumour histology complementing the currently used prognostic factors in breast cancer.
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| 38. |
- Ursby, Thomas, et al.
(author)
-
BioMAX the first macromolecular crystallography beamline at MAX IV Laboratory
- 2020
-
In: Journal of Synchrotron Radiation. - Chichester : Wiley-Blackwell. - 0909-0495 .- 1600-5775. ; 27, s. 1415-1429
-
Journal article (peer-reviewed)abstract
- BioMAX is the first macromolecular crystallography beamline at the MAX IV Laboratory 3 GeV storage ring, which is the first operational multi-bend achromat storage ring. Due to the low-emittance storage ring, BioMAX has a parallel, high-intensity X-ray beam, even when focused down to 20 μm × 5 μm using the bendable focusing mirrors. The beam is tunable in the energy range 5-25 keV using the in-vacuum undulator and the horizontally deflecting double-crystal monochromator. BioMAX is equipped with an MD3 diffractometer, an ISARA high-capacity sample changer and an EIGER 16M hybrid pixel detector. Data collection at BioMAX is controlled using the newly developed MXCuBE3 graphical user interface, and sample tracking is handled by ISPyB. The computing infrastructure includes data storage and processing both at MAX IV and the Lund University supercomputing center LUNARC. With state-of-the-art instrumentation, a high degree of automation, a user-friendly control system interface and remote operation, BioMAX provides an excellent facility for most macromolecular crystallography experiments. Serial crystallography using either a high-viscosity extruder injector or the MD3 as a fixed-target scanner is already implemented. The serial crystallography activities at MAX IV Laboratory will be further developed at the microfocus beamline MicroMAX, when it comes into operation in 2022. MicroMAX will have a 1 μm × 1 μm beam focus and a flux up to 1015 photons s with main applications in serial crystallography, room-temperature structure determinations and time-resolved experiments.
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| 39. |
- Vihinen, Pia, et al.
(author)
-
Benefit of adjuvant interferon alfa-2b (IFN-α) therapy in melanoma patients with high serum MMP-8 levels.
- 2014
-
In: Cancer Immunology, Immunotherapy. - : Springer Science and Business Media LLC. - 1432-0851 .- 0340-7004.
-
Journal article (peer-reviewed)abstract
- Matrix metalloproteinases (MMPs) are important enzymes in tissue turnover and various inflammatory processes. In this study, it was evaluated whether serum MMP-8 can predict the response to adjuvant interferon alfa-2b (IFN-α) therapy in patients with operated high-risk cutaneous melanoma. Pre-treatment sera from 460 patients with stage IIB-IIIC melanoma were analyzed for MMP-8. The patients were randomized after surgery to adjuvant IFN-α for 12 or 24 months (n = 313) or observation only (n = 147). The median serum MMP-8 level was used to classify the patients into a low MMP-8 (n = 232) and a high MMP-8 (n = 228) group. In the high MMP-8 subgroup, IFN-α therapy significantly improved relapse-free survival (RFS). RFS was 36.8 months in patients with high MMP-8 levels receiving IFN-α therapy, whereas RFS for those with high MMP-8 levels with observation only was 10.6 months (P = 0.027). Median overall survival for patients with high MMP-8 and observation only was 36.7 versus 71.7 months in those receiving IFN-α (P = 0.13). In a multivariate model, IFN-α therapy was a significant predictor of favorable RFS (HR 0.74; 95 % CI 0.55-0.99; P = 0.048), after adjustment for pre-treatment MMP-8 (HR 1.17; 95 % CI 0.88-1.55; P = 0.28), gender (HR 1.16; 95 % CI 0.86-1.56; P = 0.32), age (HR 1.00; 95 % CI 1.00-1.02; P = 0.12), ulceration (HR 1.09; 95 % CI 0.81-1.46; P = 0.58), and the presence of node metastases (HR 1.36; 95 % CI 1.17-1.58; P
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| 40. |
- Wallis, Lee, et al.
(author)
-
A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings : a focus on front-line health workers and health-system organizations
- 2017
-
In: Global Health Action. - : TAYLOR & FRANCIS LTD. - 1654-9716 .- 1654-9880. ; 10
-
Journal article (peer-reviewed)abstract
- Background: Diagnostic support for clinicians is a domain of application of mHealth technologies with a slow uptake despite promising opportunities, such as image-based clinical support. The absence of a roadmap for the adoption and implementation of these types of applications is a further obstacle. Objectives: This article provides the groundwork for a roadmap to implement image-based support for clinicians, focusing on how to overcome potential barriers affecting front-line users, the health-care organization and the technical system. Methods: A consensual approach was used during a two-day roundtable meeting gathering a convenience sample of stakeholders (n = 50) from clinical, research, policymaking and business fields and from different countries. A series of sessions was held including small group discussions followed by reports to the plenary. Session moderators synthesized the reports in a number of theme-specific strategies that were presented to the participants again at the end of the meeting for them to determine their individual priority. Results: There were four to seven strategies derived from the thematic sessions. Once reviewed and prioritized by the participants some received greater priorities than others. As an example, of the seven strategies related to the front-line users, three received greater priority: the need for any system to significantly add value to the users; the usability of mHealth apps; and the goodness-of-fit into the work flow. Further, three aspects cut across the themes: ease of integration of the mHealth applications; solid ICT infrastructure and support network; and interoperability. Conclusions: Research and development in image-based diagnostic pave the way to making health care more accessible and more equitable. The successful implementation of those solutions will necessitate a seamless introduction into routines, adequate technical support and significant added value.
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| 41. |
- Zackrisson, Björn, et al.
(author)
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Mature results from a Swedish comparison study of conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma - The ARTSCAN trial
- 2015
-
In: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 117:1, s. 99-105
-
Journal article (peer-reviewed)abstract
- Background and purpose: This report contains the mature five-year data from the Swedish ARTSCAN trial including information on the influence of p16 positivity (p16+) for oropharyngeal cancers. Material and methods: Patients with previously untreated squamous cell carcinoma without distant metastases of the oral cavity, oropharynx, larynx (except T1-2, NO glottic cancers) and hypopharynx were included. Patients were randomised between accelerated fractionation (AF) (1.1 Gy + 2 Gy per day, 5 days/week for 4.5 weeks, total dose 68 Gy) and conventional fractionation (CF) (2 Gy per day, 5 days/week for 7 weeks, total dose 68 Gy). Human papillomavirus (HPV)-associated p16-expression was assessed retrospectively in tumour tissues from patients with oropharyngeal carcinoma. Results: There was no significant difference in loco-regional control (LRC) between AF and CF (log-rank test p = 0.75). LRC at 5 years was 65.5% for AF and 64.9% for CF. Overall survival (OS) was similar in both arms (p = 0.99). The estimated cancer specific survival (CSS) at 5 years was 62.2% (AF) and 63.3% (CF) (p = 0.99). 206 specimens were analysed for p16 with 153 specimens (74%) identified as p16+. P16 status did not discriminate for response to AF vs. CF with regard to LRC, OS or CSS. Patients with p16+ tumours had a statistically significant better overall prognosis compared with p16 tumours. Conclusion: This update confirms the results of the 2-year report. We failed to identify a positive effect resulting from AF with regards to LRC, OS and CSS. The addition of information on the HPV-associated p16 overexpression did not explain this lack of effect.
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| 42. |
- Abrahamsson, Johan, 1977-
(author)
-
Kinetic Energy Storage and Magnetic Bearings : for Vehicular Applications
- 2014
-
Doctoral thesis (other academic/artistic)abstract
- One of the main challenges in order to make electric cars competitive with gas-powered cars is in the improvement of the electric power system. Although many of the energy sources currently used in electric vehicles have sufficientlyhigh specific energy, their applicability is limited due to low specific power. It would therefore be advantageous to create a driveline with the main energy storage separated from a smaller energy buffer, designed to have high power capabilities and to withstand frequent and deep discharge cycles. It has been found that rotating kinetic energy storage in flywheels is very well suited for this type of application.A composite shell, comprising an inner part made of glassfiber and an outer part made of carbonfiber, was analyzed analytically and numerically, designed, and constructed. The shell was fitted onto a metallic rotor using shrinkfitting. The cost of the shell, and the complexity of assembly, was reduced by winding the glass- and carbonfiber consecutively on a mandrel, and curing the complete assembly simultaneously. Thereby, the shell obtained an internal segmentation, without the need for fitting several concentric parts onto each other. The radial stress inside the composite shell was kept compressive thanks to a novel approach of using the permanent magnets of the integrated electric machine to provide radial mechanical load during rotation.Two thrust bearing units (one upper and one lower) comprising one segmented unit with the permanent magnets in a cylindrical Halbach configuration and one non-segmented unit in a up/down configuration were optimized, constructed and tested. Each thrust bearing unit generated 1040 N of repelling force, and a positive axial stiffness of 169 N/mm at the nominal airgap of 5 mm. Two radial active magnetic bearings (one upper and one lower) were optimized, constructed and tested. By parameterizing the shape of the actuators, a numerical optimization of force over resistive loss from the bias currentcould be performed. The optimized shape of the electromagnets was produced by watercutting sheets of laminated steel. A maximum current stiffness of120 N/A at a bias current of 1.5 A was achieved.
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| 43. |
- Adielsson, Anna, 1973, et al.
(author)
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A 20-year perspective of in hospital cardiac arrest : Experiences from a university hospital with focus on wards with and without monitoring facilities.
- 2016
-
In: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 216, s. 194-199
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Knowledge about change in the characteristics and outcome of in hospital cardiac arrests (IHCAs) is insufficient.AIM: To describe a 20year perspective of in hospital cardiac arrest (IHCA) in wards with and without monitoring capabilities.SETTINGS: Sahlgrenska University Hospital (800 beds). The number of beds varied during the time of survey from 850-746 TIME: 1994-2013.METHODS: Retrospective registry study. Patients were assessed in four fiveyear intervals.INCLUSION CRITERIA: Witnessed and nonwitnessed IHCAs when cardiopulmonary resuscitation (CPR) was attempted.EXCLUSION CRITERIA: Age below 18years.RESULTS: In all, there were 2340 patients with IHCA during the time of the survey. 30-Day survival increased significantly in wards with monitoring facilities from 43.5% to 55.6% (p=0.002) for trend but not in wards without such facilities (p=0.003 for interaction between wards with/without monitoring facilities and time period). The CPC-score among survivors did not change significantly in any of the two types of wards. In wards with monitoring facilities there was a significant reduction of the delay time from collapse to start of CPR and an increase in the proportion of patients who were defibrillated before the arrival of the rescue team. In wards without such facilities there was a significant reduction of the delay from collapse to defibrillation. However, the latter observation corresponds to a marked decrease in the proportion of patients found in ventricular fibrillation.CONCLUSION: In a 20year perspective the treatment of in hospital cardiac arrest was characterised by a more rapid start of treatment. This was reflected in a significant increase in 30-day survival in wards with monitoring facilities. In wards without such facilities there was a decrease in patients found in ventricular fibrillation.
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| 44. |
- Adielsson, A., et al.
(author)
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Changes over time in 30-day survival and the incidence of shockable rhythms after in-hospital cardiac arrest- A population-based registry study of nearly 24,000 cases
- 2020
-
In: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 157, s. 135-140
-
Journal article (peer-reviewed)abstract
- Objective: To determine changes over time in 30-day survival and the incidence of shockable rhythms after in-hospital cardiac arrest, from a countrywide perspective. Methods: Patient information from the Swedish Registry for Cardiopulmonary Resuscitation was analysed in relation to monitoring level of ward and initial rhythm. The primary outcome was defined as survival at 30 days. Changes in survival and incidence of shockable rhythms were reported per year from 2008 to 2018. Also, epidemiological data were compared between two time periods, 2008-2013 and 2014-2018. Results: In all, 23,186 unique patients (38.6% female) were included in the study. The mean age was 72.6 (SD 13.2) years. Adjusted trends indicated an overall increase in 30-day survival from 24.7% in 2008 to 32.5% in 2018, (on monitoring wards from 32.5% to 43.1% and on non-monitoring wards from 17.6% to 23.1%). The proportion of patients found in shockable rhythms decreased overall from 31.6% in 2008 to 23.6% in 2018, (on monitoring wards from 42.5% to 35.8 % and on non-monitoring wards from 20.1% to 12.9%). Among the patients found in shockable rhythms, the proportion of patients defibrillated before the arrival of cardiac arrest team increased from 71.0% to 80.9%. Conclusions: In an 11-year perspective, resuscitation in in-hospital cardiac arrest in Sweden was characterised by an overall increase in the adjusted 30-day survival, despite a decrease in shockable rhythms. An increased proportion, among the patients found in a shockable rhythm, who were defibrillated before the arrival of a cardiac arrest team may have contributed to the finding.
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| 45. |
- Adielsson, A, et al.
(author)
-
Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia : bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective
- 2011
-
In: Heart. - : B M J Group. - 1355-6037 .- 1468-201X. ; 97:17, s. 1391-1396
-
Journal article (peer-reviewed)abstract
- Objectives In a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance? Design Observational register study. Setting Sweden. Patients All patients included in the Swedish Out of Hospital Cardiac Arrest Register between 1 January 1990 and 31 December 2009 who were found in bystander-witnessed ventricular fibrillation with a presumed cardiac aetiology. Interventions Bystander cardiopulmonary resuscitation (CPR) and defibrillation. Main outcome measures Survival to 1 month. Results In all, 7187 patients fulfilled the set criteria. Age, place of out-of-hospital cardiac arrest (OHCA) and gender did not change. Bystander CPR increased from 46% to 73%; 95% CI for OR 1.060 to 1.081 per year. The median delay from collapse to defibrillation increased from 12 min to 14 min (p for trend 0.0004). Early survival increased from 28% to 45% (95% CI 1.044 to 1.065) and survival to 1 month increased from 12% to 23% (95% CI 1.058 to 1.086). Strong predictors of early and late survival were a short interval from collapse to defibrillation, bystander CPR, female gender and OHCA outside the home. Conclusion In a long-term perspective in Sweden, survival to 1 month after ventricular fibrillation almost doubled. This was associated with a marked increase in bystander CPR. Strong predictors of outcome were a short delay to defibrillation, bystander CPR, female gender and place of collapse.
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| 46. |
- Adielsson, Anna, et al.
(author)
-
Outcome prediction for patients assessed by the medical emergency team : a retrospective cohort study
- 2022
-
In: BMC Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 22:1
-
Journal article (peer-reviewed)abstract
- Background: Medical emergency teams (METs) have been implemented to reduce hospital mortality by the early recognition and treatment of potentially life-threatening conditions. The objective of this study was to establish a clinically useful association between clinical variables and mortality risk, among patients assessed by the MET, and further to design an easy-to-use risk score for the prediction of death within 30 days.Methods: Observational retrospective register study in a tertiary university hospital in Sweden, comprising 2,601 patients, assessed by the MET from 2010 to 2015. Patient registry data at the time of MET assessment was analysed from an epidemiological perspective, using univariable and multivariable analyses with death within 30 days as the outcome variable. Predictors of outcome were defined from age, gender, type of ward for admittance, previous medical history, acute medical condition, vital parameters and laboratory biomarkers. Identified factors independently associated with mortality were then used to develop a prognostic risk score for mortality.Results: The overall 30-day mortality was high (29.0%). We identified thirteen factors independently associated with 30-day mortality concerning; age, type of ward for admittance, vital parameters, laboratory biomarkers, previous medical history and acute medical condition. A MET risk score for mortality based on the impact of these individual thirteen factors in the model yielded a median (range) AUC of 0.780 (0.774-0.785) with good calibration. When corrected for optimism by internal validation, the score yielded a median (range) AUC of 0.768 (0.762-0.773).Conclusions: Among clinical variables available at the time of MET assessment, thirteen factors were found to be independently associated with 30-day mortality. By applying a simple risk scoring system based on these individual factors, patients at higher risk of dying within 30 days after the MET assessment may be identified and treated earlier in the process.
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| 47. |
- Adler, Jan-Olof, et al.
(author)
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The upgraded photon tagging facility at the MAX IV Laboratory
- 2013
-
In: Nuclear Instruments & Methods in Physics Research. Section A: Accelerators, Spectrometers, Detectors, and Associated Equipment. - : Elsevier BV. - 0167-5087 .- 0168-9002. ; 715, s. 1-10
-
Journal article (peer-reviewed)abstract
- A description is given of the upgraded photon tagging facility at the MAX IV Laboratory. Two magnetic spectrometers are used to momentum analyze post-bremsstrahlung electrons. The tagged photon range extends from 10 to 180 MeV with an energy resolution of about 300 keV. The system has been operated at rates up to 4 x 10(6) photons s(-1) MeV (-1). Different diagnostic tools are described as well as the experimental program.
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| 48. |
- Agrell, Per J., et al.
(author)
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Horizontal Carrier Coordination through Cooperative Governance Structures
- 2017
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In: International Journal of Production Economics. - : Elsevier BV. - 0925-5273. ; 194, s. 59-72
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Journal article (peer-reviewed)abstract
- This paper examines how governance structures found in the trucking industry impact the coordination between a forwarder and its carriers, including three cases: no forwarder coordination (direct contracting with shippers), investor-owned coordination (price-only contract), and carrier-cooperative coordination (revenue-sharing contract). The carriers are engaged in a Cournot competition, where they decide upon service provision and truck investment. Economic theory predicts that integration of firms under oligopolistic competition always leads to a more efficient supply chain in the sense that prices decrease and quantities increase, which reduces total profits. This suggests that the benefit of avoiding double marginalization does not outweigh the benefit of upstream competition in the successive oligopoly case, whereas both integrated and independent firms coexist, the integrated chains do perform better. In this paper we examine the interaction between governance structures, a key decision when managing supply chains, including that found in the trucking industry, and shippers willingness to procure trucking services instead of producing them using a private fleet. We find that cooperative governance can contribute to improved service provision, reduced service price, improved consumer surplus, and improved profit for the carriers in equilibrium. We use parameter values based on the Swedish trucking industry and a larger grocery retailer acting as shipper to numerically illustrate the impact of different governance structures.
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| 49. |
- Al Jebali, Ramsey, et al.
(author)
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A helium gas scintillator active target for photoreaction measurements
- 2015
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In: European Physical Journal A. Hadrons and Nuclei. - : Springer Science and Business Media LLC. - 1434-6001. ; 51:10
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Journal article (peer-reviewed)abstract
- A multi-cell He gas scintillator active target, designed for the measurement of photoreaction cross sections, is described. The target has four main chambers, giving an overall thickness of 0.103 g/cm(3) at an operating pressure of 2MPa. Scintillations are read out by photomultiplier tubes and the addition of small amounts of N-2 to the He, to shift the scintillation emission from UV to visible, is discussed. First results of measurements at the MAX IV Laboratory tagged-photon facility show that the target has a timing resolution of around 1 ns and can cope well with a high-flux photon beam. The determination of reaction cross sections from target yields relies on a Monte Carlo simulation, which considers scintillation light transport, photodisintegration processes in He-4, background photon interactions in target windows and interactions of the reaction-product particles in the gas and target container. The predictions of this simulation are compared to the measured target response.
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| 50. |
- Allen-Perkins, Alfonso, et al.
(author)
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CropPol : a dynamic, open and global database on crop pollination
- 2022
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In: Ecology. - : Wiley. - 0012-9658 .- 1939-9170. ; 103:3
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Journal article (peer-reviewed)abstract
- Seventy five percent of the world's food crops benefit from insect pollination. Hence, there has been increased interest in how global change drivers impact this critical ecosystem service. Because standardized data on crop pollination are rarely available, we are limited in our capacity to understand the variation in pollination benefits to crop yield, as well as to anticipate changes in this service, develop predictions, and inform management actions. Here, we present CropPol, a dynamic, open and global database on crop pollination. It contains measurements recorded from 202 crop studies, covering 3,394 field observations, 2,552 yield measurements (i.e. berry weight, number of fruits and kg per hectare, among others), and 47,752 insect records from 48 commercial crops distributed around the globe. CropPol comprises 32 of the 87 leading global crops and commodities that are pollinator dependent. Malus domestica is the most represented crop (32 studies), followed by Brassica napus (22 studies), Vaccinium corymbosum (13 studies), and Citrullus lanatus (12 studies). The most abundant pollinator guilds recorded are honey bees (34.22% counts), bumblebees (19.19%), flies other than Syrphidae and Bombyliidae (13.18%), other wild bees (13.13%), beetles (10.97%), Syrphidae (4.87%), and Bombyliidae (0.05%). Locations comprise 34 countries distributed among Europe (76 studies), Northern America (60), Latin America and the Caribbean (29), Asia (20), Oceania (10), and Africa (7). Sampling spans three decades and is concentrated on 2001-05 (21 studies), 2006-10 (40), 2011-15 (88), and 2016-20 (50). This is the most comprehensive open global data set on measurements of crop flower visitors, crop pollinators and pollination to date, and we encourage researchers to add more datasets to this database in the future. This data set is released for non-commercial use only. Credits should be given to this paper (i.e., proper citation), and the products generated with this database should be shared under the same license terms (CC BY-NC-SA). This article is protected by copyright. All rights reserved.
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