238 research outputs found
Att mäta korruption - har valet av index betydelse?
Information about the level of corruption is today widely used in research, by aid donors and as decision support for investments. A rising demand for information has led to several new organizations’ attempt at measuring it. This study examines the issues that might arise when using a particular index since the indices might differ. By studying correlations between the indices we find that depending on how you look upon them the impression of corruption might vary. When comparing the absolute numbers of the indices we conclude that they differ in ways in which could affect user purposes. We also conclude that their ranking correlate very well despite their different methodologies which could mean that they are able to observe an elusive concept
Aktieägarnas betydelse- En studie av ersättningssystemens utformning i noterade bolag
Uppsatsens syfte är att undersöka hur ägarinflytande, i form av ägarkoncentration och ägartyp i ett företag, påverkar det monetära ersättningssystemets utformning till företagets verkställande direktör i svenska noterade bolag. Detta har skett genom en kvantitativ studie, där sekundära källor i form av årsredovisningar har studerats. Utifrån datan har statistiska tester utförts, för att undersöka olika samband mellan ägarkoncentration, ägartyp och ersättningssystemens utformning. Resultaten som har konstaterats visar att ägande, i form av ägarkoncentration och en viss typ av ägandeskap, har betydelse för ersättningens sammansättning. Företag med hög ägarkoncentration använder sig av färre ersättningskomponenter, medan företag med låg ägarkoncentration har ett ersättningssystem som innehåller fler komponenter. Vidare kan ett samband mellan ett passivt ägandeskap och fler ersättningskomponenter konstateras
Circadian variation in renal blood flow and kidney function in healthy volunteers monitored using non-invasive magnetic resonance imaging
Circadian regulation of kidney function is involved in maintaining whole-body homeostasis and dysfunctional circadian rhythm can potentially be involved in disease development. Magnetic Resonance Imaging (MRI)provides reliable and reproducible repetitive estimates of kidney function non-invasively without the risk of adverse events associated with contrast agents and ionizing radiation. The purpose of this study was to estimate circadian variations in kidney function in healthy human subjects using MRI, and relate the findings with urinary excretions of electrolytes and markers of kidney function.Phase Contrast imaging, Arterial Spin Labeling and Blood Oxygen Level DependentR2*-mapping were used to assess the total renal blood flow and regional perfusion,and intrarenal oxygenation in eight female and eight male healthy volunteers every fourth hour during a 24hperiod. Parallel with MRI scans, standard urinary and plasma parameters were quantified. Significant circadian variations of total renal blood flow were found over 24hwith increasing flow from noon to midnight and decreasing flow during the night. In contrast, no circadian variation in intrarenal oxygenation was detected.Urinary excretions of electrolytes, osmotically active particles, creatinine and urea all displayed circadian variations, peaking during the afternoon and evening hours.In conclusion, total renal blood flow and kidney function, as estimated from excretion of electrolytes and waste products, display profound circadian variations, whereas intrarenal oxygenation displays significantly less circadian variation
Glycaemic control, disease duration and beta-cell function in patients with Type 2 diabetes in a Swedish community. Skaraborg Hypertension and Diabetes Project.
AimsTo examine determinants for glycaemic control in primary care patients with Type 2 diabetes. MethodsIn a community-based surveillance of primary care patients with Type 2 diabetes, 190 men and 186 women were consecutively identified and examined for cardiovascular risk factors. Insulin resistance and beta-cell function were estimated using homeostasis model assessment (HOMA). Good glycaemic control was defined as HbA1c = 6.5% was associated with duration of diabetes (10.6 vs. 6.4 years, P = 6.5% by 5 years diabetes duration = 1.7; 95% confidence interval (CI) 1.4-2.1) but was lost following additional adjustment for beta-cell function (OR for HbA1c>= 6.5% = 1.3; 95% CI 0.96-1.7). In a separate linear regression with beta-cell function as the dependent variable there was a significant association with HbA1c after adjustments for differences in age, gender, WHR, serum triglyceride levels and diabetes duration (P < 0.001). ConclusionsIncreasing HbA1c by time was associated with declining beta-cell function
Consensus-Based Technical Recommendations for Clinical Translation of Renal Phase Contrast MRI
BACKGROUND:
Phase-contrast (PC) MRI is a feasible and valid noninvasive technique to measure renal artery blood flow, showing potential to support diagnosis and monitoring of renal diseases. However, the variability in measured renal blood flow values across studies is large, most likely due to differences in PC-MRI acquisition and processing. Standardized acquisition and processing protocols are therefore needed to minimize this variability and maximize the potential of renal PC-MRI as a clinically useful tool.
PURPOSE:
To build technical recommendations for the acquisition, processing, and analysis of renal 2D PC-MRI data in human subjects to promote standardization of renal blood flow measurements and facilitate the comparability of results across scanners and in multicenter clinical studies.
STUDY TYPE:
Systematic consensus process using a modified Delphi method.
POPULATION:
Not applicable.
SEQUENCE FIELD/STRENGTH:
Renal fast gradient echo-based 2D PC-MRI.
ASSESSMENT:
An international panel of 27 experts from Europe, the USA, Australia, and Japan with 6 (interquartile range 4–10) years of experience in 2D PC-MRI formulated consensus statements on renal 2D PC-MRI in two rounds of surveys. Starting from a recently published systematic review article, literature-based and data-driven statements regarding patient preparation, hardware, acquisition protocol, analysis steps, and data reporting were formulated.
STATISTICAL TESTS:
Consensus was defined as ≥75% unanimity in response, and a clear preference was defined as 60–74% agreement among the experts.
RESULTS:
Among 60 statements, 57 (95%) achieved consensus after the second-round survey, while the remaining three showed a clear preference. Consensus statements resulted in specific recommendations for subject preparation, 2D renal PC-MRI data acquisition, processing, and reporting.
DATA CONCLUSION:
These recommendations might promote a widespread adoption of renal PC-MRI, and may help foster the set-up of multicenter studies aimed at defining reference values and building larger and more definitive evidence, and will facilitate clinical translation of PC-MRI.
LEVEL OF EVIDENCE:
1
TECHNICAL EFFICACY STAGE:
Decreased renal perfusion during acute kidney injury in critical COVID-19 assessed by magnetic resonance imaging: a prospective case control study
Abstract: Background: Renal hypoperfusion has been suggested to contribute to the development of acute kidney injury (AKI) in critical COVID-19. However, limited data exist to support this. We aim to investigate the differences in renal perfusion, oxygenation and water diffusion using multiparametric magnetic resonance imaging in critically ill COVID-19 patients with and without AKI. Methods: A prospective case–control study where patients without prior kidney disease treated in intensive care for respiratory failure due to COVID-19 were examined. Kidney Disease: Improving Global Outcomes Creatinine criteria were used for group allocation. Main comparisons were tested using Mann–Whitney U test. Results: Nineteen patients were examined, ten with AKI and nine without AKI. Patients with AKI were examined in median 1 [0–2] day after criteria fulfillment. Age and baseline Plasma-Creatinine were similar in both groups. Total renal blood flow was lower in patients with AKI compared with patients without (median 645 quartile range [423–753] vs. 859 [746–920] ml/min, p = 0.037). Regional perfusion was reduced in both cortex (76 [51–112] vs. 146 [123–169] ml/100 g/min, p = 0.015) and medulla (28 [18–47] vs. 47 [38–73] ml/100 g/min, p = 0.03). Renal venous saturation was similar in both groups (72% [64–75] vs. 72% [63–84], ns.), as was regional oxygenation (R2*) in cortex (17 [16–19] vs. 17 [16–18] 1/s, ns.) and medulla (29 [24–39] vs. 27 [23–29] 1/s, ns.). Conclusions: In critically ill COVID-19 patients with AKI, the total, cortical and medullary renal blood flows were reduced compared with similar patients without AKI, whereas no differences in renal oxygenation were demonstrable in this setting. Trial registration ClinicalTrials ID: NCT02765191, registered May 6 2014 and updated May 7 2020. Graphic Abstract
Interference of partial visual analysis of root filling quality and apical status on retreatment decisions
OBJECTIVE: The presence of periapical radiolucency has been used as a criterion for endodontic treatment failure. However, in addition to the inherent limitations of radiographic examinations, radiographic interpretations are extremely subjective. Thus, this study investigated the effect of partial analysis of root filling quality and periapical status on retreatment decisions by general dentists. MATERIAL AND METHODS: Twelve digitalized periapical radiographs were analyzed by 10 observers. The study was conducted at three time points at 1-week intervals. Radiographs edited with the Adobe Photoshop CS4 software were analyzed at three time points: first, only root filling quality was analyzed; second, only the periapical areas of the teeth under study were visualized; finally, observers analyzed the unedited radiographic image. Spearman's coefficient was used to analyze the correlations between the scores assigned when the periapical area was not visible and when the unedited radiograph was analyzed, as well as between the scores assigned when root fillings where not visible and when the unedited radiograph was analyzed. Sensitivity, specificity, positive and negative predictive values between partial images and unedited radiographs were also used to analyze retreatment decisions. The level of significance was set at 5%. RESULTS: The visualization of the root filling on the unedited radiograph affected the interpretation of the periapical status and the technical quality of the fillings has a greater influence on the general dentist's decision to prescribe endodontic retreatment than the periapical condition. CONCLUSION: In order to make endodontic diagnosis, radiographic interpretation process should not only emphasize technical aspects, but also consider biological factors
Ethnic differences in dissatisfaction with sexual life in patients with type 2 diabetes in a Swedish town
<p>Abstract</p> <p>Background</p> <p>The first aim of this study was to analyze whether self-reported satisfaction with one's sexual life was associated with ethnicity (Swedish and Assyrian/Syrian) in patients with type 2 diabetes. The second was to study whether the association between satisfaction with one's sexual life and ethnicity remained after controlling for possible confounders such as marital status, HbA1c, medication, and presence of other diseases.</p> <p>Methods</p> <p>This cross-sectional, questionnaire-based study was conducted at four primary health care centers in the Swedish town of Södertälje. A total of 354 persons (173 ethnic Assyrians/Syrians and 181 ethnic Swedes) participated.</p> <p>Results</p> <p>The total prevalence of self-reported dissatisfaction with one's sexual life in both groups was 49%. No significant ethnic differences were found in the outcome. In the final model, regardless of ethnicity, the odds ratio (OR) for self-reported dissatisfaction with one's sexual life in those ≥ 70 years old was 2.52 (95% CI 1.33-4.80). Among those living alone or with children, the OR was more than three times higher than for married or cohabiting individuals (OR = 3.10, 95% CI 1.60-6.00). Those with other diseases had an OR 1.89 times (95% CI 1.10-3.40) higher than those without other diseases.</p> <p>Conclusions</p> <p>The findings demonstrate that almost half of participants were dissatisfied with their sexual life and highlight the importance of sexual life to people with type 2 diabetes. This factor should not be ignored in clinical evaluations. Moreover, the findings demonstrate that it is possible to include questions on sexual life in investigations of patients with type 2 diabetes and even in other health-related, questionnaire studies, despite the sensitivity of the issue of sexuality.</p
Detection of upper extremity deep vein thrombosis by magnetic resonance non-contrast thrombus imaging
Background Compression ultrasonography (CUS) is the first-line imaging test for diagnosing upper extremity deep vein thrombosis (UEDVT), but often yields inconclusive test results. Contrast venography is still considered the diagnostic standard but is an invasive technique.Objectives We aimed to determine the diagnostic accuracy of magnetic resonance noncontrast thrombus imaging (MR-NCTI) for the diagnosis of UEDVT.Methods In this international multicenter diagnostic study, we prospectively included patients with clinically suspected UEDVT who were managed according to a diagnostic algorithm that included a clinical decision rule (CDR), D-dimer test, and diagnostic imaging. UEDVT was confirmed by CUS or (computed tomography [CT]) venography. UEDVT was excluded by (1) an unlikely CDR and normal D-dimer, (2) a normal serial CUS or (3) a normal (CT) venography. Within 48 h after the final diagnosis was established, patients underwent MR-NCTI. MR-NCTI images were assessed post hoc by two independent radiologists unaware of the presence or absence of UEDVT. The sensitivity, specificity, and interobserver agreement of MR-NCTI for UEDVT were determined.Results Magnetic resonance noncontrast thrombus imaging demonstrated UEDVT in 28 of 30 patients with UEDVT and was normal in all 30 patients where UEDVT was ruled out, yielding a sensitivity of 93% (95% CI 78-99) and specificity of 100% (95% CI 88-100). The interobserver agreement of MR-NCTI had a kappa value of 0.83 (95% CI 0.69-0.97).Conclusions Magnetic resonance noncontrast thrombus imaging is an accurate and reproducible method for diagnosing UEDVT. Clinical outcome studies should determine whether MR-NCTI can replace venography as the second-line imaging test in case of inconclusive CUS.Cardiovascular Aspects of Radiolog
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