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- Khatri, C, et al.
(author)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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In: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Journal article (peer-reviewed)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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- Beukes, Eldre W., et al.
(author)
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Readability Following Cultural and Linguistic Adaptations of an Internet-Based Intervention for Tinnitus for Use in the United States
- 2020
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In: American Journal of Audiology. - Rockville, MD, United States : AMER SPEECH-LANGUAGE-HEARING ASSOC. - 1059-0889 .- 1558-9137. ; 29:2, s. 97-109
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Journal article (peer-reviewed)abstract
- Purpose: An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitusrelated services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this study was to improve the cultural and linguistic suitability, and lower the readability level, of an existing program for tinnitus to ensure its suitability for U.S. English- and Spanish-speaking populations. Method: Guidelines for adaptation were followed and involved four phases: (a) cultural adaptations, as interventions targeted at specific cultures have been shown to improve outcomes; (b) creating Spanish materials to improve access of the materials to the large Spanish-speaking population in the United States; (c) professional review of the materials for acceptability as an intervention tool for a U.S. population; and (d) literacy-level adjustments to make the content accessible to those with lower levels of health literacy skills. Results: Cultural adaptations were made by using word substitutions, changing examples, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured suitability of the chapters. Literacy-level adjustments ensured all chapters were within the guidelines for readability grade levels below the sixth-grade level. Conclusions: The previously developed tinnitus materials were revised to adhere to best practice guidelines and ensure cultural suitability for adults with tinnitus in the United States. As it is also available in Spanish, members of the large Hispanic community also have access to the intervention in their first language. Further studies should determine whether these changes improve patients self-efficacy, engagement, and motivation to complete the intervention.
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- Bousquet, J, et al.
(author)
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Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies
- 2020
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In: Clinical and translational allergy. - : Wiley. - 2045-7022. ; 10:1, s. 58-
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Journal article (peer-reviewed)abstract
- There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPARγ:Peroxisome proliferator-activated receptor, NFκB: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2α:Elongation initiation factor 2α). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT1R axis (AT1R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity.
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- Sahlberg, Arne
(author)
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Multi-sightline neutron emission spectroscopy of D and T fusion plasmas at JET
- 2021
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Doctoral thesis (other academic/artistic)abstract
- An analysis of the neutron emission from a fusion plasma can be used to determine plasma properties and diagnose fusion performance. In this thesis, several analysis methods for neutron spectroscopy are presented and applied to data from the experimental fusion device JET. JET has numerous instruments for neutron measurements installed, and data from several of them are used in this thesis.The work presented here describes how various plasma parameters affect the neutron emission and how this information can be used to determine properties of the fusion plasma. Forward fitting of models parameterized in terms of the relevant plasma properties are a central part of most of the analysis methods and are used to determine key features of supra-thermal (“fast”) ion distributions for prediction of plasma performance in deuterium-tritium (d-t) experiments, and to determine the branching ratio for the formation of a short-lived 5He resonance in t+t reactions. The thesis also includes work concerning uncertainty quantification of the modeling of the neutron emission rate and the calculation of pile-up distortion of light-yield spectra from liquid scintillator detectors.A major contribution of this thesis is the novel methods for measuring properties of a fast-ion distribution using neutron spectroscopy with multiple sightlines. The combination of data from instruments viewing different parts of the plasma and/or with different viewing angles permits us to study fast-ion behavior in a more consistent and detailed fashion than if we analyze each measurement separately. Another interesting result is the first-ever observation of the neutron spectrum from t+t reactions in a magnetically confined fusion plasma, from which we can learn important things about the t+t reaction in reactor relevant conditions.
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- Tiselius, Elisabet, 1967-
(author)
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Experience and Expertise in Conference Interpreting : An investigation of Swedish conference interpreters
- 2013
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Doctoral thesis (other academic/artistic)abstract
- Avhandlingen undersöker tolkningsprocessen och tolkprodukten hos konferenstolkar med olika lång tolkerfarenhet. Detta görs utifrån expertteorin (jmf Ericsson, Charness och Hoffman 2007) tillämpad på tolkning. Enligt expertteorin använder mycket skickliga utövare, oberoende av fält, samma typer av processer och strategier för att nå den absoluta toppen inom sitt gebit. En viktig del av expertteorin är medveten eller avsiktlig övning (deliberate practice), en särskild typ av övning som mycket skickliga utövare använder sig av för att förbättra sin insats.Avhandlingen bygger på fyra olika studier om två olika grupper av deltagare. Deltagarna simultantolkar ett eller två tal från engelska till svenska. Två grupper – en tvärsnittsgrupp med nio deltagare på tre olika tolkerfarenhetsnivåer (ingen erfarenhet, kort erfarenhet och lång erfarenhet) samt en longitudinellgrupp med tre deltagare som spelats in vid två olika tillfällen med 15 års mellanrum – analyserades utifrån både process och produkt data. Tolkprocessen studerades genom att analysera och kategorisera process problem, monitorering och tolkstrategier som tolkarna rapporterat om under retrospektion efter tolkning. Tolkprodukten analyserades genom holistiska bedömningsskalor, en för förståelighet och en för nivån på informationsöverföring. Vidare genomfördes också djupintervjuer med deltagarna i det longitudinella materialet. Syftet var att undersöka hur de uppfattade medveten/avsiktlig övning och hur de såg på sin utveckling och övning av tolkfärdigheten. En viktig del av avhandlingen, förutom resultaten, är utvecklingen av de holistiska bedömningsskalorna (utvecklade från Carroll 1966) och utvecklingen av metoden i djupintervjustudien.Slutsatsen i avhandlingen är att det finns en mätbar skillnad i tolkfärdigheten mellan tolkar med liten eller ingen tolkerfarenhet och tolkar med lång tolkerfarenhet. Denna slutsats fick dock inte stöd i det longitudinella (och intra-individuella) materialet. Skillnaderna mellan grupperna i tvärsnittsmaterialet var också tydliga i processdata. Erfarna tolkar stöter på färre process problem än tolkar med kortare erfarenhet. Det fanns också tydliga skillnader vad gäller förekomsterna av monitorering (alltså kontroll av tolkprocessen och produktionen) mellan erfarna tolkar och övriga deltagare. Monitorering verkar vara en skiljelinje mellan erfarna och oerfarna tolkar, de erfarna tolkarna hade mer process kapacitet tillgänglig för att monitorera sig själva. Detta stöddes också till viss del av djupintervjuerna, där deltagarna rapporterade hur de ständigt utvärderar sig själva i syfte att förbättra sin insats. Ett nyckelantagande som slogs fast i början av projektet – nämligen att erfarna tolkar skulle hävda i djupintervjuerna att de ägnade mycket tid åt att öva färdigheten – fick, till författarens förvåning, inte stöd. Tolkarna rapporterade om många övningslika aktiviteter, men hävdade samtidigt att de inte övade.Avhandlingen avslutas genom ett önskemål om fler studier med fokus på medveten/avsiktlig övning bland tolkar. Dessutom föreslår författaren också att termen “experttolk” eller “expert” ska användas med stor försiktighet i forskningsstudier om just expertkunnande i tolkning. Författaren efterlyser också en bredare diskussion om expertkunnande och medveten/avsiktlig övning.
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| 16. |
- Bravo, L, et al.
(author)
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- 2021
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swepub:Mat__t
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| 17. |
- Tabiri, S, et al.
(author)
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- 2021
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swepub:Mat__t
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| 18. |
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- 2018
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In: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:1
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Research review (peer-reviewed)
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- Bombarda, F., et al.
(author)
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Runaway electron beam control
- 2019
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In: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 1361-6587 .- 0741-3335. ; 61:1
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Journal article (peer-reviewed)
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