A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (TRANSFORM)

Rationale: Single-center randomized controlled trials of the Zephyr endobronchial valve (EBV) treatment have demonstrated benefit in severe heterogeneous emphysema. This is the first multicenter study evaluating this treatment approach. Objectives: To evaluate the efficacy and safety of Zephyr EBVs in patients with heterogeneous emphysema and absence of collateral ventilation. Methods: This was a prospective, multicenter 2:1 randomized controlled trial of EBVs plus standard of care or standard of care alone (SoC). Primary outcome at 3 months post-procedure was the percentage of subjects with FEV1 improvement from baseline of 12% or greater. Changes in FEV1, residual volume, 6-minute-walk distance, St. George's Respiratory Questionnaire score, and modified Medical Research Council score were assessed at 3 and 6 months, and target lobe volume reduction on chest computed tomography at 3 months. Measurements and Main Results: Ninety seven subjects were randomized toEBV(n = 65) or SoC(n = 32). At 3 months, 55.4% of EBV and 6.5% of SoC subjects had an FEV1 improvement of 12% or more (P <0.001). Improvements were maintained at 6 months: EBV 56.3% versus SoC 3.2% (P <0.001), with a mean +/- SD change in FEV1 at 6 months of 20.7 +/- 29.6% and -8.6 +/- 13.0%, respectively. A total of 89.8% of EBV subjects had target lobe volume reduction greater than or equal to 350 ml, mean 1.09 +/- 0.62 L (P <0.001). Between-group differences for changes at 6 months were statistically and clinically significant: Delta EBV-SoC for residual volume, -700 ml; 6-minute-walk distance, +78.7 m; St. George's Respiratory Questionnaire score, -6.5 points; modified Medical Research Council dyspnea score, -0.6 points; and BODE(body mass index, airflow obstruction, dyspnea, and exercise capacity) index, 21.8 points (all P <0.05). Pneumothorax was the most common adverse event, occurring in 19 of 65 (29.2%) of EBV subjects. Conclusions: EBV treatment in hyperinflated patients with heterogeneous emphysema without collateral ventilation resulted in clinically meaningful benefits in lung function, dyspnea, exercise tolerance, and quality of life, with an acceptable safety profile

Assessment of function of a 3D-printed body-powered upper limb prosthetic device

Purpose Conventional arm-prosthesis are expensive to make and therefore limit the availability for users on the geographical locations there the user pays for it. This study compares the hand function of a 3D-printed prosthesis with lower production cost with a traditional prosthesis. Method A test person performed two different tests of hand function (Box and Block test and Nine-hole peg test) with a myoelectric trans radial prosthetic arm and a body powered 3D printed trans radial prosthetic arm. The test person also answered two parts of the orthotics and prosthetics users’ survey (OPUS) considering both prosthetic arms. Result The 3D-printed prosthesis performed worse than the traditional prosthesis in the two tests of hand function and generally worse in the questionnaire about the function of the prosthesis. Though it got higher values in comfort and affordability. Conclusion There was a significant difference in function between the 3D-printed prosthesis and the myoelectric prosthesis but the printed prosthesis could perform many activities in daily living. Whether the 3D-printed prosthetic device is priceworthy or not is hard to measure because of different criteria, therefore a conclusion is hard to reach

Estetiska kvaliteter och skillnader i preferenser för limfog : en jämförelse mellan två intervjumetoder

Den produktgrupp som här studerats är limfog för Gör-Det-Själv-marknaden. Limfog är en vanlig produkt som konsumenter köper styckevis och där träets estetiska blandning av träegenskaper kan vara av betydelse för ett aktivt val eller köp av kunden. Projektets övergripande mål var att studera vanliga konsumenters olika känslighet (smakprofiler) för olika utseenden på trä. Huvudmålet med studien var att jämföra två metoder för preferensmätning; dels användandet av riktiga träytor (limfog) och dels digitala bilder av desamma för rangordning av produktalternativ. För att validera användbarheten av de båda metoderna jämfördes deras rangordningsresultat. Ett delmål med studien var att studera skillnader mellan preferenser för limfog som producerats enligt alternativa produktionssätt med traditionellt producerad limfog. Femton personer intervjuades i två omgångar. I den första intervjun fick personerna rangordna 11 limfogsytor med hjälp av datorbilder och en webapplikation. I den andra intervjun två veckor senare fick samma personer rangordna samma limfogsytor fast nu med riktiga träytor. Resultaten från intervjuerna visar att de båda metoderna gav likvärdiga resultat. Det fungerade bra att använda digitala bilder och utföra preferensstudier via utvecklad web-applikation. För båda metoderna gällde att 11 stycken produktalternativ var på gränsen till för många att ta ställning till för de intervjuade personerna. Detta gällde båda intervjumetoderna. Bildernas kvalitet visade sig vara viktigt och de små skillnader i rangordningsresultat mellan de två intervjumetoderna kan till viss del förklaras av bristande återgivning av färgnyanser. Metoden att rangordna de verkliga limfogsskivorna fungerade mycket bra. Principen att välja ömsom bäst och sämst och kontinuerligt plocka bort valda produktalternativ fungerade bra. Följande estetiska kvalitetsskillnader visade sig vara viktiga för intervjupersonerna: En jämn fördelning av kvistar över ytan (limfogen) tillika blandning av kvistutseende är viktigt för helhetsintrycket. Märgstråk upplevdes starkt negativt då de ses som streck i ytan, en artefakt. Detta gäller också hög grad av randighet som upplevdes negativt. Detta kan orsakas av splint-/kärnvedsvariationer, speciellt när limfogen producerats med låg lamellbredd. Negativt var också tjurvedsstråk som orsakar randighet i en yta, vilket stör den visuella balansen och harmonin. Den limfog som producerats inom ramen för en ny högutbytesstrategi rankades högre än den traditionellt tillverkade limfogen som var inköpt. Detta kan förklaras främst av en hög grad av färska kvistar (ej svarta och eller döda kvistar), som kommer sig av valet av råvara. Råvaran utgjordes av klentimmer medan råvaran till den traditionellt tillverkade limfogen kom från plank med ursprung från osorterat timmer. Slutsatsen är att för limfog så har valet av råvara minst lika stor betydelse än produktionssätt (lamellbredd, koniska lameller etc) för det estetiska uttrycket och kundtillfredsställelse.Godkänd; 2008; 20080422 (ysko

Framtidens biobaserade byggande och boende : Slutrapport

The aim of the project "Biobased building and living for the future" was to create conditions for increased use of bio-based products and services in the construction sector in Sweden and Europe and to increase the competitiveness of the Swedish timber manufacturing industry. The project has shown ways to develop E-commerce, parts of the production where increased digitalization leads to increased capacity and quality, as well as solutions for development of floor systems, external walls and tall timber buildings. The project has shown development opportunities to increase the use of bio-based products that implemented will increase competitiveness. The project has been divided into eleven sub-projects to study the various aspects of external factors, market conditions and business models, process development and product development. Within each sub-project, several workshops have been carried out to jointly evaluate results and decide the next step in the sub-project. Through joint workshops, the partners have also been able to meet and share results across the sub-projects and spread knowledge and create networks within the industry. The last part is perceived as very valuable by both the companies and the academy / institute. For the joinery value chain, a current situation analysis has been carried out and shown how the development of E-commerce platforms must be combined with process development in order to have a large effect. The results will be utilized in the companies' strategy work ahead. For the timber building value chain, demonstrators have shown development opportunities for both process and product development. The next step for the companies is to evaluate the various solutions linked to their own production conditions

Slutrapport : Framtidens biobaserade byggande och boende

The aim of the project “Biobased building and living for the future” was to create conditions for increased use of bio-based products and services in the construction sector in Sweden and Europe and to increase the competitiveness of the Swedish timber manufacturing industry. The project has shown ways to develop E-commerce, parts of the production where increased digitalization leads to increased capacity and quality, as well as solutions for development of floor systems, external walls and tall timber buildings. The project has shown development opportunities to increase the use of bio-based products that implemented will increase competitiveness. The project has been divided into eleven sub-projects to study the various aspects of external factors, market conditions and business models, process development and product development. Within each sub-project, several workshops have been carried out to jointly evaluate results and decide the next step in the sub-project. Through joint workshops, the partners have also been able to meet and share results across the subprojects and spread knowledge and create networks within the industry. The last part is perceived as very valuable by both the companies and the academy / institute. For the joinery value chain, a current situation analysis has been carried out and shown how the development of E-commerce platforms must be combined with process development in order to have a large effect. The results will be utilized in the companies' strategy work ahead. For the timber building value chain, demonstrators have shown development opportunities for both process and product development. The next step for the companies is to evaluate the various solutions linked to their own production conditions