Abstract
The present study focuses on introducing the concept of optimisation and proposing a model, including evaluation of image quality, to be used in the clinical routines where image-guided ...intervention is being performed. The overall aim of the study was to develop a model for evaluating the use of imaging in X-ray-guided interventional procedures and its possible implications on optimisation of radiation protection. In the search for an adequate evaluation model, data from endovascular interventions of the aorta (EVAR procedures) were used. The procedure was schematically described in steps. Every imaging event was connected to the steps in the medical procedure and was also described with the purpose of the imaging event. Available technical, as well as procedural parameters, were studied and analysed. Data were collected from the X-ray equipment for 70 EVAR procedures and, out of these, 12 procedures were randomly selected to be recorded on video to understand the procedure better. It was possible to describe the EVAR procedures in a general way with explanations of the clinical purpose connected to each imaging event. Possible quality parameters of the procedure were identified for the imaging events (radiation dose, image quality). The model method still needs to be refined and will then be applied to clinical data and to other clinical procedures to test the validity.
Objective
Guided Internet‐based cognitive behaviour therapy (ICBT) for panic disorder has been shown to be efficacious in several randomized controlled trials. However, the effectiveness of the ...treatment when delivered within routine psychiatric care has not been studied. The aim of this study was to investigate the effectiveness of ICBT for panic disorder within the context of routine psychiatric care.
Method
We conducted a cohort study investigating all patients (n = 570) who had received guided ICBT for panic disorder between 2007 and 2012 in a routine care setting at an out‐patient psychiatric clinic providing Internet‐based treatment. The primary outcome measure was the Panic Disorder Severity Scale‐Self‐report (PDSS‐SR).
Results
Participants made large improvements from screening and pretreatment assessments to posttreatment (Cohen's d range on the PDSS‐SR = 1.07–1.55). Improvements were sustained at 6‐month follow‐up.
Conclusion
This study suggests that ICBT for panic disorder is as effective when delivered in a routine care context as in the previously published randomized controlled trials.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Soft tissue preservation using a hydroxyapatite-coated abutment in bone conduction hearing implant surgery may lead to improved clinical outcomes over the short (1 year) and long term (3 years).
In ...this open multi-center, randomized (1:1), controlled clinical trial, subjects with conductive, mixed hearing loss or single-sided sensorineural deafness were randomly assigned to receive the conventional intervention, a titanium abutment with soft tissue reduction surgery (control), or a new intervention, a hydroxyapatite-coated abutment with soft tissue preservation surgery (test). The primary efficacy outcome was the combined endpoint of numbness, pain, peri-abutment dermatitis, and soft tissue thickening/overgrowth after 1 and 3 years.
The Intention-to-treat (ITT) population consisted of 52 control subjects and 51 test subjects. The difference between the groups after 1 year of follow-up as measured by the primary efficacy outcome was not statistically significant (
= 0.12) in the ITT population (
= 103), but did reach statistical significance (
= 0.03) in the per-protocol (PP) population (
= 96). It showed an advantage for the test group, with over twice as many subjects (29%) without these medical events during the first year compared to the control group (13%). After 3 years, the difference between the two groups had declined and did not reach statistical significance (24 vs. 10%, ITT
= 0.45). Secondary outcome measures which showed a statistical significant difference during the first year, such as surgical time (15 vs. 25 minutes,
< 0.0001), numbness (90 vs. 69% of subjects experienced no numbness at 1 year,
< 0.01), neuropathic pain at 3 months (
= 0.0087) and the overall opinion of the esthetic outcome (observer POSAS scale at 3 months,
< 0.01) were favorable for the test group. More soft tissue thickening/overgrowth was observed at 3 weeks for the test group (
= 0.016). Similar results were achieved for the long term follow up.
Soft tissue preservation with a hydroxyapatite-coated abutment leads to a reduction in the combined occurrence of complications over the first year which is not statistically significant in the ITT population but is in the PP population. This effect decreased for the long-term study follow up of 3 years and did also not reach statistical significance.
The goal of the current study was to perform dynamic bending experiments on legs and thighs from post mortem human surrogates (PMHS) and combine the failure data with that of previous applicable ...studies to perform an injury risk analysis. Four leg and 12 thigh specimens were loaded dynamically (∼1.5 m/s) in latero-medial 3-point bending. The four leg specimens and six of the thigh specimens were loaded at the mid-diaphysis and the other 6 thigh specimens were loaded at a third of the length from the distal end. Data from four other studies were used with data from the current study to develop injury risk functions for the human thigh loaded at the distal third (50% probability of femur fracture = 372 Nm), and at the mid shaft (50% probability of femur fracture = 447 Nm) and for the human leg loaded at the mid shaft (50% probability of tibia fracture = 312 Nm).
Full text
Available for:
BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
Coronal head impacts were simulated in a physical model, based on the hypothesis that acute subdural hematoma (ASDH) is related to cerebral vertex displacement and diffuse axonal injury (DAI) to ...local Green–Lagrange strain. The geometry of the 2D model was based on anatomical measurements taken from the MRI scans of 10 adult males. Silicone gel modelled the cerebrum, paraffin the CSF and elastic membranes the trabeculae of the sulci. Pendulum impacts gave peak angular acceleration of 7800
rad
s
−2 in models with and without sulci. The motion of the gel and Green–Lagrange strain were calculated from tracked coordinates of Patrick markers. Worst-case bridging vein strains are produced on the contrecoup side and are approximately doubled by adding sulci. Given that axons in the corpus callosum are highly oriented, Green–Lagrange strain was resolved in the fibre direction. It is found to be close to the minimum principal strain, indicating a degree of natural, teleological protection for the axons. The data support the use of
Δ
θ
.
peak
as a suitable descriptor for the risk of DAI but not for ASDH.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
•We compare injury and other characteristics of pure and multi-event rollover crashes.•Pure and single vehicle primary rollover crashes can be considered collectively.•Planar impact contributes to ...injury in non-primary crashes with 0 or 1 roof inversion.
Planar impacts with objects and other vehicles may increase the risk and severity of injury in rollover crashes. The current study compares the frequency of injury measures (MAIS 2+, 3+, and 4+; fatal; AIS 2+ head and cervical spine; and AIS 3+ head and thorax) as well as vehicle type distribution (passenger car, SUV, van, and light truck), crash kinematics, and occupant demographics between single vehicle single event rollovers (SV Pure) and multiple event rollovers to determine which types of multiple event rollovers can be pooled with SV Pure to study rollover induced occupant injury. Four different types of multiple event rollovers were defined: single and multi-vehicle crashes for which the rollover is the most severe event (SV Prim and MV Prim) and single and multi-vehicle crashes for which the rollover is not the most severe event (SV Non-Prim and MV Non-Prim). Information from real world crashes was obtained from the National Automotive Sampling System – Crashworthiness Data System (NASS-CDS) for the period from 1995 through 2011. Belted, contained or partially ejected, adult occupants in vehicles that completed 1–16 lateral quarter turns were assigned to one of the five rollover categories. The results showed that the frequency of injury in non-primary rollovers (SV Non-Prim and MV Non-Prim) involving no more than one roof inversion is substantially greater than in SV Pure, but that this disparity diminishes for crashes involving multiple inversions. It can further be concluded that for a given number of roof inversions, the distribution of injuries and crash characteristics in SV Pure and SV Prim crashes are sufficiently similar for these categories to be considered collectively for purposes of understanding etiologies and developing strategies for prevention.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
7.
A double-talk detector based on coherence Gansler, T.; Hansson, M.; Ivarsson, C.-J. ...
IEEE transactions on communications,
11/1996, Volume:
44, Issue:
11
Journal Article
Peer reviewed
We address the problem of detecting double-talk in a full duplex transmission line. A new double-talk detector (DTD) based on measuring the similarity between the far- and near-end speech signals is ...proposed. The detector is block oriented and operates in the frequency domain where the similarity between the signals is measured by means of the coherence function. The coherence is estimated with a short sequence of data by exploiting the multiple window spectrum estimation technique. Theoretical evaluation and examples of its performance are presented. The proposed DTD operates accurately in a wide range of situations, i.e., a difference in speech levels and hybrid attenuations ranging from 0 to 20 dB.
Objectives. The present study examined the influence of age on the morbidity and mortality of pedestrian victims while controlling for confounding factors.
Methods. The Pedestrian Crash Data Study ...(PCDS) database was used for a cross-sectional study to compare the outcome of senior (age ≥60 years) and adult (age 19 to 50 years) pedestrian victims. The outcome measures were the Injury Severity Score (ISS), Maximum Abbreviated Injury Score (MAIS), Abbreviated Injury Scale (AIS), and Mortality. Logistic regression models were used to estimate age-associated risks while controlling for confounders such as vehicle type, impact speed, and pedestrian height, weight, and gender.
Results. Compared to the adult victims, the seniors had a higher average ISS (23 vs. 16, p = 0.018) and higher mortality (30 percent vs. 11 percent, p ≤ 0.001). The seniors were also more likely to have an ISS ≥9 (odds ratio = 2.72; 95 percent CI: 1.31-5.68) and to die (odds ratio = 6.68; 95 percent CI: 2.37-19.88). The seniors were approximately twice as likely to have higher AIS scores to almost every body region.
Conclusions. The adjusted age-dependent risks indicated by the current study should be considered when calculating or projecting pedestrian morbidity and mortality. Adjustment in statistical models is essential to achieve precise risk estimates and in turn to appropriately allocate public health rescores.
Full text
Available for:
BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
During 2001 and 2002, the first international comparison of surface temperature measurements at national metrology institutes (NMIs) was organized under EUROMET Project No 635. The coordinator for ...this project was the National Office of Measures (OMH) in Hungary. Among the participants were the Swedish National Testing and Research Institute (SP) from Sweden, the Centre for Metrology and Accreditation (MIKES) in Finland, and Justervesenet (JV) in Norway. The comparison showed a need for better apparatus to reduce the differences in the results from the different laboratories. As a result, a new apparatus was designed at SP and MIKES made some changes to their apparatus. To test the new and modified apparatus, SP took the initiative to arrange and coordinate a new comparison. In this recent comparison, measurements were made at temperatures from 50 to 300°C on surfaces of aluminum and stainless steel. The comparison was arranged and performed during 2005 and 2006. Participants in the comparison were OMH, MIKES, RISOE, JV, and SP. The comparison results using the newly developed apparatus show improved agreement with the earlier EUROMET intercomparison, but also indicate a need for a more standardized calibration method and apparatus to be able to perform calibrations in different laboratories with good agreement.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
PDF
