Left Ventricular Longitudinal Function Assessed by Speckle Tracking Ultrasound from a Single Apical Imaging Plane

Background. Transthoracic ultrasonography of the heart is valuable in monitoring and treatment of critically ill patients. Speckle tracking ultrasound (STU) has proven valid in estimating left ventricular systolic deformation. The aims of the study were to compare conventional and automated STU and to determine whether left ventricular systolic deformation could be estimated from one single imaging plane. Methods. 2D-echocardiography cine-loops were obtained from 20 patients for off-line speckle tracking analysis, consisting of manually tracing of the endocardial border (conventional method) or automatically drawn boundaries (automated method). Results. We found a bias of 0,6 (95% CI −2.2−3.3) for global peak systolic strain comparing the automated and the conventional method. Comparing global peak systolic strain of apical 4-chamber cine-loops with averaged Global Peak Strain obtained from apical 4, 2 and long axis cine-loops, showed a bias of 0.1 (95% CI −3.9−4.0). The agreement between subcostal 4-chamber and apical 4-chamber global peak systolic strain was 4.4 (95% CI −3.7−12.5). Conclusion. We found good agreement between the conventional and the automated method. STU applied to single apical 4-chamber cine-loops is in excellent agreement with overall averaged global peak systolic strain, while subcostal 4-chamber cine-loops proved less compliant with speckle tracking ultrasound

Danske Landbrugsorganisationer efter 1945 - hovedtræk og betragtninger

I denne artikel vil jeg give et overblik over udviklingen indenfor de danske landbrugsorganisationer efter Den 2. Verdenskrig. Det er en skildring, der ikke alene lægger vægt på sammenhængen mellem organisationerne, økonomien og de politiske forhold, men også indeholder personlige betragtninger fra 40 års virke i centrale dele af landbrugsorganisationerne

Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer:a register based cohort-study

Abstract Background Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested as a potential cause of the poor prognosis and as consequence, fast track cancer care pathways were implemented describing maximum acceptable time thresholds from referral to treatment. In Denmark, patients with lung cancer are often transferred between hospitals with diagnostic facilities to hospitals with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis and treatment of Non-Small Cell Lung Cancer (NSCLC). Methods We performed a historical prospective cohort study using data from the Danish Lung Cancer Registry (DLCR). All patients diagnosed with primary NSCLC from January 1st 2008 to December 31st 2012 were included. Patients with unresolved pathology and incomplete data on the dates of referral, diagnosis and treatment were excluded. Results A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68–0.96)) and in total time from referral to treatment (HR 0.84 (0.77–0.92)), than no-transfer patients. Transfer patients had lower odds of being diagnosed (Odds Ratio (OR) 0.82 (0.74–0.94) and treated (OR 0.66 (0.61–0.72) within the acceptable time thresholds described in the care pathway. Conclusion Fast track cancer care pathways were implemented to unify and accelerate the diagnosis and treatment of cancer. We found that the transfer between hospitals during the care pathway might cause delay from diagnosis to treatment as well as in the total time from referral to treatment in patients with Non Small-Cell Lung Cancer. The difference between no-transfer and transfer patients persists after adjusting for known predictors of delay

Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer:a register based cohort-study

Abstract Background Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested as a potential cause of the poor prognosis and as consequence, fast track cancer care pathways were implemented describing maximum acceptable time thresholds from referral to treatment. In Denmark, patients with lung cancer are often transferred between hospitals with diagnostic facilities to hospitals with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis and treatment of Non-Small Cell Lung Cancer (NSCLC). Methods We performed a historical prospective cohort study using data from the Danish Lung Cancer Registry (DLCR). All patients diagnosed with primary NSCLC from January 1st 2008 to December 31st 2012 were included. Patients with unresolved pathology and incomplete data on the dates of referral, diagnosis and treatment were excluded. Results A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68–0.96)) and in total time from referral to treatment (HR 0.84 (0.77–0.92)), than no-transfer patients. Transfer patients had lower odds of being diagnosed (Odds Ratio (OR) 0.82 (0.74–0.94) and treated (OR 0.66 (0.61–0.72) within the acceptable time thresholds described in the care pathway. Conclusion Fast track cancer care pathways were implemented to unify and accelerate the diagnosis and treatment of cancer. We found that the transfer between hospitals during the care pathway might cause delay from diagnosis to treatment as well as in the total time from referral to treatment in patients with Non Small-Cell Lung Cancer. The difference between no-transfer and transfer patients persists after adjusting for known predictors of delay

Foreign firm location and local multiplier effects : the case of Norwegian industrial towns

The Foreign Direct Investment (FDI) theory show that these investments form regional effects. Our paper emphasis the heterogeneity of these effects. Different motives for FDI creates different multiplier effects, such as jobs, increased local production and new firms. Our study focus on two different industrial towns in Norway, where natural resources have attracted the foreign firms in the first town, while access to intangible technology resources has been the main attraction in the second. We compare differences and similarities in the way these investments have influenced local linkages and local growth processes. Here we draw on the theoretical contribution from the management model as well as the network model. Our findings indicates that foreign ownership per se do not explain multiplier effects. The motives, the sector-specific characteristics and the history of the local production system provide more reasonable explanations

One coast, two systems: Regional innovation systems and entrepreneurial discovery in Western Norway

This paper introduces an analytical framework for understanding how specialized and diversified regional innovation system (RIS) differ in the way an entrepreneurial discovery process (EDP) is likely to unfold. To analytically explore the proposed framework, we deploy a sequential explanatory design approach, using quantitative data to analyze the regional industry structure of the city regions of Bergen and Stavanger in Western Norway, followed by a qualitative analysis of interviews with key stakeholders in both regions. We find that the city regions face unique challenges that align with an understanding of their respective RIS categorization, providing evidence that the framework proposed serves as a useful guide in understanding the development of an EDP.publishedVersio