1. |
- Aad, G, et al.
(författare)
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- 2015
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swepub:Mat__t
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2. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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3. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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4. |
- Khatri, C, et al.
(författare)
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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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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)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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5. |
- Alimena, Juliette, et al.
(författare)
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Searching for long-lived particles beyond the Standard Model at the Large Hadron Collider
- 2020
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Ingår i: Journal of Physics G. - : IOP Publishing. - 0954-3899 .- 1361-6471. ; 47:9
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Tidskriftsartikel (refereegranskat)abstract
- Particles beyond the Standard Model (SM) can generically have lifetimes that are long compared to SM particles at the weak scale. When produced at experiments such as the Large Hadron Collider (LHC) at CERN, these long-lived particles (LLPs) can decay far from the interaction vertex of the primary proton-proton collision. Such LLP signatures are distinct from those of promptly decaying particles that are targeted by the majority of searches for new physics at the LHC, often requiring customized techniques to identify, for example, significantly displaced decay vertices, tracks with atypical properties, and short track segments. Given their non-standard nature, a comprehensive overview of LLP signatures at the LHC is beneficial to ensure that possible avenues of the discovery of new physics are not overlooked. Here we report on the joint work of a community of theorists and experimentalists with the ATLAS, CMS, and LHCb experiments-as well as those working on dedicated experiments such as MoEDAL, milliQan, MATHUSLA, CODEX-b, and FASER-to survey the current state of LLP searches at the LHC, and to chart a path for the development of LLP searches into the future, both in the upcoming Run 3 and at the high-luminosity LHC. The work is organized around the current and future potential capabilities of LHC experiments to generally discover new LLPs, and takes a signature-based approach to surveying classes of models that give rise to LLPs rather than emphasizing any particular theory motivation. We develop a set of simplified models; assess the coverage of current searches; document known, often unexpected backgrounds; explore the capabilities of proposed detector upgrades; provide recommendations for the presentation of search results; and look towards the newest frontiers, namely high-multiplicity 'dark showers', highlighting opportunities for expanding the LHC reach for these signals.
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6. |
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7. |
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8. |
- Scannell, B. C., et al.
(författare)
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Probing the sensitivity of electron wave interference to disorder-induced scattering in solid-state devices
- 2012
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Ingår i: Physical Review B (Condensed Matter and Materials Physics). - 1098-0121. ; 85:19
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Tidskriftsartikel (refereegranskat)abstract
- The study of electron motion in semiconductor billiards has elucidated our understanding of quantum interference and quantum chaos. The central assumption is that ionized donors generate only minor perturbations to the electron trajectories, which are determined by scattering from billiard walls. We use magnetoconductance fluctuations as a probe of the quantum interference and show that these fluctuations change radically when the scattering landscape is modified by thermally induced charge displacement between donor sites. Our results challenge the accepted understanding of quantum interference effects in nanostructures.
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9. |
- Andersson, V., et al.
(författare)
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Large-Area Balloon-Borne Polarized Gamma Ray Observer (PoGO)
- 2005
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Ingår i: Proceedings of the 22nd Texas Symposium on Relativistic Astrophysics at Stanford. ; , s. 736-743
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Konferensbidrag (refereegranskat)abstract
- We are developing a new balloon-borne instrument (PoGO), to measure polarization of soft gamma rays (30-200 keV) using asymmetry in azimuth angle distribution of Compton scattering. PoGO is designed to detect 10 % polarization in 100mCrab sources in a 6-8 hour observation and bring a new dimension to studies on gamma ray emission/transportation mechanism in pulsars, AGNs, black hole binaries, and neutron star surface. The concept is an adaptation to polarization measurements of well-type phoswich counter consisting of a fast plastic scintillator (the detection part), a slow plastic scintillator (the active collimator) and a BGO scintillator (the bottom anti-counter). PoGO consists of close-packed array of 217 hexagonal well-type phoswich counters and has a narrow field-of-view (~ 5 deg2) to reduce possible source confusion. A prototype instrument has been tested in the polarized soft gamma-ray beams at Advanced Photon Source (ANL) and at Photon Factory (KEK). On the results, the polarization dependence of EGS4 has been validated and that of Geant4 has been corrected.
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10. |
- Marlow, C. A., et al.
(författare)
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Unified model of fractal conductance fluctuations for diffusive and ballistic semiconductor devices
- 2006
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Ingår i: Physical Review B (Condensed Matter and Materials Physics). - 1098-0121. ; 73:19
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Tidskriftsartikel (refereegranskat)abstract
- We present an experimental comparison of magnetoconductance fluctuations measured in the ballistic, quasiballistic, and diffusive scattering regimes of semiconductor devices. In contradiction to expectations, we show that the spectral content of the magnetoconductance fluctuations exhibits an identical fractal behavior for these scattering regimes and that this behavior is remarkably insensitive to device boundary properties. We propose a unified model of fractal conductance fluctuations in the ballistic, quasiballistic, and diffusive transport regimes, in which the generic fractal behavior is generated by a subtle interplay between boundary and material-induced chaotic scattering events.
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11. |
- Martin, T P, et al.
(författare)
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Confinement properties of a Ga0.25In0.75As/InP quantum point contact
- 2008
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Ingår i: Physical Review B (Condensed Matter and Materials Physics). - 1098-0121. ; 77:15, s. 5-155309
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Tidskriftsartikel (refereegranskat)abstract
- We study the electrostatic confinement properties of a ballistic GaInAs nanostructure, a system with a high potential for quantum applications due to its small effective mass and persistence of quantum effects to higher temperatures. By measuring the magnetic depopulation of one-dimensional subbands in an etched quantum point contact, we demonstrate that the slope of the confinement at the Fermi level is an order of magnitude steeper than in surface-gated devices, indicating that this system is ideal for applications that are sensitive to the boundary geometry of devices. The subband spacing is found to range from 7 to 9.5 meV, which is significantly larger than previously reported for this material system.
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12. |
- Martin, T. P., et al.
(författare)
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Enhanced Zeeman splitting in Ga0.25In0.75As quantum point contacts
- 2008
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Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 93:1
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Tidskriftsartikel (refereegranskat)abstract
- The strength of the Zeeman splitting induced by an applied magnetic field is an important factor for the realization of spin-resolved transport in mesoscopic devices. We measure the Zeeman splitting for a quantum point contact etched into a Ga0.25In0.75As quantum well, with the field oriented parallel to the transport direction. We observe an enhancement of the Lande g-factor from vertical bar g*vertical bar=3.8 +/- 0.2 for the third subband to vertical bar g*vertical bar=5.8 +/- 0.6 for the first subband, six times larger than in GaAs. We report subband spacings in excess of 10 meV, which facilitates quantum transport at higher temperatures. (C) 2008 American Institute of Physics.
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13. |
- Martin, T. P., et al.
(författare)
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Field-orientation dependence of the Zeeman spin splitting in (In,Ga)As quantum point contacts
- 2010
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Ingår i: Physical Review B (Condensed Matter and Materials Physics). - 1098-0121. ; 81:4
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Tidskriftsartikel (refereegranskat)abstract
- We study the Zeeman spin splitting in a quantum point contact (QPC) etched into an InGaAs/InP heterostructure for three orthogonal magnetic field orientations with respect to the QPC. For the two in-plane orientations we observe an isotropic Zeeman spin splitting, which becomes stronger as the system is made more one dimensional. The Lande g factor is enhanced by up to a factor of two compared to two-dimensional electron systems in InGaAs/InP. A much larger Zeeman splitting is observed when the field is oriented perpendicular to the heterostructure, resulting in a g factor of 15.7 in the one-dimensional limit.
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14. |
- Micolich, A. P., et al.
(författare)
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Is it the boundaries or disorder that dominates electron transport in semiconductor `billiards'?
- 2013
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Ingår i: Fortschritte der Physik. - : Wiley. - 0015-8208. ; 61:2-3, s. 332-347
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Forskningsöversikt (refereegranskat)abstract
- Semiconductor billiards are often considered as ideal systems for studying dynamical chaos in the quantum mechanical limit. In the traditional picture, once the electron's mean free path, as determined by the mobility, becomes larger than the device, disorder is negligible and electron trajectories are shaped by specular reflection from the billiard walls alone. Experimental insight into the electron dynamics is normally obtained by magnetoconductance measurements. A number of recent experimental studies have shown these measurements to be largely independent of the billiard's exact shape, and highly dependent on sample-to-sample variations in disorder. In this paper, we discuss these more recent findings within the full historical context of work on semiconductor billiards, and offer strong evidence that small-angle scattering at the sub-100 nm length-scale dominates transport in these devices. This has important implications for the role these devices can play for experimental tests of ideas in quantum chaos. (C) 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim
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15. |
- Moslehi, S., et al.
(författare)
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Fractal Electronics for Stimulating and Sensing Neural Networks : Enhanced Electrical, Optical, and Cell Interaction Properties
- 2024
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Ingår i: The Fractal Geometry of the Brain. - 2190-5215 .- 2190-5223. - 9783031476051 - 9783031476068 ; 36, s. 849-875
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Bokkapitel (refereegranskat)abstract
- Imagine a world in which damaged parts of the body – an arm, an eye, and ultimately a region of the brain – can be replaced by artificial implants capable of restoring or even enhancing human performance. The associated improvements in the quality of human life would revolutionize the medical world and produce sweeping changes across society. In this chapter, we discuss several approaches to the fabrication of fractal electronics designed to interface with neural networks. We consider two fundamental functions – stimulating electrical signals in the neural networks and sensing the location of the signals as they pass through the network. Using experiments and simulations, we discuss the favorable electrical performances that arise from adopting fractal rather than traditional Euclidean architectures. We also demonstrate how the fractal architecture induces favorable physical interactions with the cells they interact with, including the ability to direct the growth of neurons and glia to specific regions of the neural–electronic interface.
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16. |
- Mylrea-Foley, Bronacha, et al.
(författare)
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Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction
- 2023
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Ingår i: Ultraschall in der Medizin. - : Georg Thieme Verlag KG. - 0172-4614. ; 44:1, s. 56-67
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). Materials and Methods A prospective European multicenter observational study included women with a singleton pregnancy, 32 +0-36 +6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] <10 th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of >40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (<0.9) or abnormal (≥0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements. Results 856 women had 2770 measurements; 696 (81%) had more than one measurement (median 3 (IQR 2-4). At inclusion, 63 (7%) a UCR ≥0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30% vs. 9%, relative risk 3.2; 95%CI 2.1-5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67% (95%CI 55-80), but after a normal UCR the chance of finding an abnormal UCR was 6% (95%CI 5-7%). The risk of composite adverse outcome was similar using the first or subsequent UCR values. Conclusion An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5-7% when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR.
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17. |
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18. |
- Stampalija, T., et al.
(författare)
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Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction : prospective cohort study
- 2020
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Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 56:2, s. 173-181
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction. Methods This was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32+ 0 to 36+ 6weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and/or abdominal circumference (AC) < 10th percentile, abnormal arterial Doppler and/or a fall in AC growth velocity of more than 40 percentile points from the 20-week scan. Composite adverse outcome comprised both immediate adverse birth outcome and major neonatal morbidity. Using a range of cut-off values, the association of MCA pulsatility index and umbilicocerebral ratio (UCR) with composite adverse outcome was explored. Results The study population comprised 856 women. There were two (0.2%) intrauterine deaths. Median gestational age at delivery was 38 (interquartile range (IQR), 37-39) weeks and birth weight was 2478 (IQR, 2140-2790) g. Compared with infants with normal outcome, those with composite adverse outcome (n= 93; 11%) were delivered at an earlier gestational age (36 vs 38 weeks) and had a lower birth weight (1900 vs 2540 g). The first Doppler observation of MCA pulsatility index < 5th percentile and UCR Z-score above gestational-age-specific thresholds (1.5 at 32-33weeks and 1.0 at 34-36weeks) had the highest relative risks (RR) for composite adverse outcome (RR 2.2 (95% CI, 1.5-3.2) and RR 2.0 (95% CI, 1.4-3.0), respectively). After adjustment for confounders, the association between UCR Z-score and composite adverse outcome remained significant, although gestational age at delivery and birth-weight Z-score had a stronger association. Conclusion In this prospective multicenter study, signs of cerebral blood flow redistribution were found to be associated with adverse outcome in late preterm singleton pregnancies at risk of fetal growth restriction. Whether cerebral redistribution is a marker describing the severity of fetal growth restriction or an independent risk factor for adverse outcome remains unclear, and whether it is useful for clinical management can be answered only in a randomized trial. (C) 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.
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19. |
- Fairbanks, M. S., et al.
(författare)
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Measuring hybridization in GaInAs/InP electron billiard arrays
- 2010
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Ingår i: Physica E: Low-dimensional Systems and Nanostructures. - : Elsevier BV. - 1386-9477. ; 42:4, s. 1205-1207
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Konferensbidrag (refereegranskat)abstract
- We study low temperature magnetoconductance fluctuations in arrays of electron billiards in an effort to quantitatively measure hybridization between array elements. In contrast to previous research in the 'open' regime, which is mostly limited to the canonical AlxGa1-xAs/GaAs heterostructure, our devices are etched into the Ga0.25In0.75As/InP heterostructure. To chart hybridization (i.e. the extent of the coherent electron wavefunction) in the arrays, we use a Fourier analysis to examine the frequency content of the universal conductance fluctuations in one and two element arrays. This analysis reveals strong evidence of wavefunction hybridization over all measured coupling strengths between the array elements. (c) 2009 Elsevier B.V. All rights reserved.
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20. |
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21. |
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22. |
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23. |
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24. |
- Kish, L.B., Otten, F., Vandamme, L.K.J., Vajtai, R., Granqvist, C.G., Marlow, B., Kruis, E., Fissan, H., Ederth, J., Chaoguang, P.
(författare)
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Noise Measurements and Fluctuation Analysis in Nanoparticle Films
- 2001
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Ingår i: Advanced Research Workshop on Semiconductor Nanostructures, 2001, New Zealand. Paper presented by L.B. Kish, as an invited talk, at the Advanced Research Workshop on Semiconductor Nanostructures, 5-9 February, 2001, Qeenstown, New Zealand..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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25. |
- Kish, L.B., Solis, J.L., Vajtai, R., Granqvist, C.G., Olsson, J., Schnurer, J., Lantto, V., Marlow, W.H., Gingl, Z.
(författare)
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How can noise “smell” and remember that “smell”
- 2001
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Ingår i: 16th International Conference on Noise in Physical Systems and 1/f Fluctuations, Gainesville Florida, October 22-25, 2001. Paper to be presented by L.B. Kish..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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26. |
- Kish, LB, et al.
(författare)
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Noise measurements and fluctuation analysis in nanoparticle films
- 2001
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Ingår i: PHYSICA E. - : ELSEVIER SCIENCE BV. - 1386-9477. ; 11:2-3, s. 131-136
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Tidskriftsartikel (refereegranskat)abstract
- This work reports two different ways of study providing potentially important information about nanoparticle films. The first study is about conductance noise in PbS nanoparticle films. Monocrystalline and single-sized PbS nanoparticles are synthesized vi
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27. |
- Krastev, DB, et al.
(författare)
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The ubiquitin-dependent ATPase p97 removes cytotoxic trapped PARP1 from chromatin
- 2022
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Ingår i: Nature cell biology. - : Springer Science and Business Media LLC. - 1476-4679 .- 1465-7392. ; 24:1, s. 62-
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Tidskriftsartikel (refereegranskat)abstract
- Poly (ADP-ribose) polymerase (PARP) inhibitors elicit antitumour activity in homologous recombination-defective cancers by trapping PARP1 in a chromatin-bound state. How cells process trapped PARP1 remains unclear. Using wild-type and a trapping-deficient PARP1 mutant combined with rapid immunoprecipitation mass spectrometry of endogenous proteins and Apex2 proximity labelling, we delineated mass spectrometry-based interactomes of trapped and non-trapped PARP1. These analyses identified an interaction between trapped PARP1 and the ubiquitin-regulated p97 ATPase/segregase. We found that following trapping, PARP1 is SUMOylated by PIAS4 and subsequently ubiquitylated by the SUMO-targeted E3 ubiquitin ligase RNF4, events that promote recruitment of p97 and removal of trapped PARP1 from chromatin. Small-molecule p97-complex inhibitors, including a metabolite of the clinically used drug disulfiram (CuET), prolonged PARP1 trapping and enhanced PARP inhibitor-induced cytotoxicity in homologous recombination-defective tumour cells and patient-derived tumour organoids. Together, these results suggest that p97 ATPase plays a key role in the processing of trapped PARP1 and the response of tumour cells to PARP inhibitors.
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28. |
- Löfgren, Anneli, et al.
(författare)
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Symmetry of magnetoconductance fluctuations of quantum dots in the nonlinear response regime
- 2006
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Ingår i: Physical Review B (Condensed Matter and Materials Physics). - 1098-0121. ; 73:23
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Tidskriftsartikel (refereegranskat)abstract
- We investigate the symmetry of magnetoconductance fluctuations of phase-coherent, two-terminal quantum dots in the nonlinear regime of transport. Specifically, we consider open, ballistic quantum dots (electron billiards) with and without symmetry axes parallel and perpendicular to the current direction and formulate a set of novel symmetry relations not observed in devices with lower symmetry. We experimentally confirm these relations, demonstrating that high-quality materials and modern semiconductor technology allow the fabrication of devices with almost perfect symmetry. Small deviations from the intended symmetry, presumably due to impurities and fabrication limitations, do exist and can be detected. We also take into account circuit-induced asymmetries of the measured conductance due to bias-dependent depletion and demonstrate that this effect can be experimentally distinguished from rectification effects that are due to a lack of device symmetry. Some open questions regarding the role of a magnetic field in the nonlinear regime of transport are highlighted.
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29. |
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30. |
- Martin, T. P., et al.
(författare)
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Carrier density saturation in a Ga0.25In0.75As/InP heterostructure
- 2008
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Ingår i: Physica E: Low-Dimensional Systems and Nanostructures. - : Elsevier BV. - 1386-9477. ; 40:5, s. 1754-1756
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Tidskriftsartikel (refereegranskat)abstract
- We observe a strong saturation of the carrier density in the quantum well of a Ga0.25In0.75As/InP MISFET at positive gate voltages. Using a self-consistent Schrodinger/Poisson solver, we model the band structure and find that the saturation is caused by the population of charge states between the gate and the quantum well. We discuss the impact of these charge states on the transport properties, and present a fabrication method that avoids parallel conduction in this heterostructure. (C) 2007 Elsevier B.V. All rights reserved.
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31. |
- Martin, T. P., et al.
(författare)
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Investigation of electron wave function hybridization in Ga0.25In0.75As/InP arrays
- 2009
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Ingår i: Applied Physics Letters. - : AIP Publishing. - 0003-6951 .- 1077-3118. ; 95:18
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Tidskriftsartikel (refereegranskat)abstract
- We present a measurement technique for quantifying coupling between semiconductor quantum dots in an array. This technique employs magnetoconductance fluctuations to probe the decrease in the average spacing of the quantum energy levels as the electron wave functions in the dots undergo hybridization. Focusing on Ga0.25In0.75As dots, we investigate hybridization as the coupling strength is varied and the number of dots in the array is increased. Our technique reveals a significant drop in the average energy level spacing for multiple dot arrays, which is strong evidence for wave function hybridization.
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32. |
- Martin, T. P., et al.
(författare)
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Series summation of fractal fluctuations in electron billiard arrays
- 2006
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Ingår i: Proceedings of the 16th International Conference on Electronic Properties of Two-Dimensional Systems (EP2DS-16) (Physica E: Low-dimensional Systems and Nanostructures). - : Elsevier BV. - 1386-9477. ; 34:1-2, s. 600-603
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Konferensbidrag (refereegranskat)abstract
- We fabricate a single billiard, a double billiard array, and a triple billiard array by etching a GaInAs/InP heterostructure, and perform a fractal analysis of the low-temperature magneto-conductance fluctuations measured in the billiards to facilitate an empirical study of how fractals combine in a physical system. We compare our results to simulated fractal traces, and find for both experiment and simulation that fluctuations of similar fractal dimension combine to form fluctuations of the same fractal dimension. (c) 2006 Elsevier B.V. All rights reserved.
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33. |
- Phattharapornjaroen, Phatthranit, et al.
(författare)
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Community-based response to the COVID-19 pandemic: case study of a home isolation centre using flexible surge capacity.
- 2022
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Ingår i: Public health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 211, s. 29-36
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Tidskriftsartikel (refereegranskat)abstract
- Coronavirus disease 2019 (COVID-19) has consumed many available resources within contingency plans, necessitating new capacity surges and novel approaches. This study aimed to explore the possibility of implementing the concept of flexible surge capacity to reduce the burden on hospitals by focussing on community resources to develop home isolation centres in Bangkok, Thailand.A qualitative study consisted of observational and semi-structured interview data.The development and activities of home isolation centres were observed, and interviews were conducted with leaders and operational workforces. Data were deductively analysed and categorised based on the practical elements necessary in disaster and emergency management.Data were categorised into the seven collaborative elements of the major incident medical management and support model. The command-and-control category demonstrated four subcategories: (1) coordination and collaboration; (2) staff engagement; (3) responsibility clarification; and (4) sustainability. Safety presented two subcategories: (1) patients' information privacy and treatment; and (2) personnel safety and privacy. Communication showed internal and external communications subcategories. Assessment, triage, treatment and transport followed the processes of the COVID-19 treatment protocols according to the World Health Organisation (WHO) guidelines and hospital operations. Several supply- and patient-related challenges were identified and managed during centre development.The use of community resources, based on the flexible surge capacity concept, is feasible under restricted circumstances and reduced the burden on hospitals during the COVID-19 pandemic. Continuous education among multidisciplinary volunteer teams facilitated their full participation and engagement. The concept of flexible surge capacity may promote an alternative community-based care opportunity, irrespective of emergencies' aetiology.
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34. |
- Spencer, Rebecca, et al.
(författare)
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EVERREST prospective study : A 6-year prospective study to define the clinical and biological characteristics of pregnancies affected by severe early onset fetal growth restriction
- 2017
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fetal growth restriction (FGR) is a serious obstetric condition for which there is currently no treatment. The EVERREST Prospective Study has been designed to characterise the natural history of pregnancies affected by severe early onset FGR and establish a well phenotyped bio-bank. The findings will provide up-to-date information for clinicians and patients and inform the design and conduct of the EVERREST Clinical Trial: a phase I/IIa trial to assess the safety and efficacy of maternal vascular endothelial growth factor (VEGF) gene therapy in severe early onset FGR. Data and samples from the EVERREST Prospective Study will be used to identify ultrasound and/or biochemical markers of prognosis in pregnancies with an estimated fetal weight (EFW) <3rd centile between 20+0 and 26+6 weeks of gestation. Methods: This is a 6 year European multicentre prospective cohort study, recruiting women with a singleton pregnancy where the EFW is <3rd centile for gestational age and <600 g at 20+0 to 26+6 weeks of gestation. Detailed data are collected on: maternal history; antenatal, peripartum, and postnatal maternal complications; health economic impact; psychological impact; neonatal condition, progress and complications; and infant growth and neurodevelopment to 2 years of corrected age in surviving infants. Standardised longitudinal ultrasound measurements are performed, including: fetal biometry; uterine artery, umbilical artery, middle cerebral artery, and ductus venosus Doppler velocimetry; and uterine artery and umbilical vein volume blood flow. Samples of maternal blood and urine, amniotic fluid (if amniocentesis performed), placenta, umbilical cord blood, and placental bed (if caesarean delivery performed) are collected for bio-banking. An initial analysis of maternal blood samples at enrolment is planned to identify biochemical markers that are predictors for fetal or neonatal death. Discussion: The findings of the EVERREST Prospective Study will support the development of a novel therapy for severe early onset FGR by describing in detail the natural history of the disease and by identifying women whose pregnancies have the poorest outcomes, in whom a therapy might be most advantageous. The findings will also enable better counselling of couples with affected pregnancies, and provide a valuable resource for future research into the causes of FGR. Trial registration:NCT02097667registered 31st October 2013.
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35. |
- Spencer, Rebecca, et al.
(författare)
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Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction
- 2023
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Ingår i: Journal of Clinical Investigation. - 0021-9738. ; 133:18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. Severe, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth. METHODS. Women with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data. RESULTS. The most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94). CONCLUSION. Ultrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.
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