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- Larsson, David, 1986, et al.
(författare)
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Cardiovascular risk factor assessment in late-onset seizures: A study protocol to assess the value of structured intervention
- 2024
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Ingår i: EPILEPSIA OPEN. - 2470-9239. ; 9:4, s. 1611-1617
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveA growing body of evidence suggests patients with late-onset seizures are at an increased risk of stroke, but the potential for reducing cardiovascular morbidity through risk factor screening and management is unknown. We aim to determine whether individuals with new-onset unprovoked seizures after middle age should undergo vascular risk assessment. The long follow-up needed to assess stroke risk and the known benefit of vascular risk factor modification make a standard RCT logistically and ethically challenging. Instead, we propose and have developed a protocol for a cluster project assessing the effect of vascular risk factor screening in an intervention trial as well as a cohort study.MethodsParticipating neurology clinics will implement standard cardiovascular risk factor assessment into the routine evaluation for individuals aged >= 50 years attending their first specialized consultation after an unprovoked seizure, excluding those with progressive brain disease. The project has two interlinked components: a prospective single group trial, in which risk factor assessment is performed and subsequent management is followed for one year; and a register-based cohort study examining the long-term effects of the intervention on a system level by comparing patients attending initial consultations in the 2 years after start of the study, with patients seen in the four preceding years at the same clinics.AnalysisThe primary outcome of the intervention trial is the proportion of patients receiving subsequent pharmacological treatment. The primary outcome of the cohort study is the incidence of acute stroke in the Swedish Stroke Register.Ethics and DisseminationSwedish Ethical Review Authority approval (which is valid for 2 years only) will be sought when funding is obtained. The results will be disseminated through peer-reviewed scientific publications.Registration DetailsThe study will be registered at .Plain Language SummaryA first seizure in a middle-aged or older person indicates a higher risk of stroke. It is not known whether investigating and treating blood pressure, blood cholesterol, or similar risk factors after a first seizure is an effective way to prevent stroke. A traditional clinical study would need too many patients and it would be unethical not to treat the control group. We have designed a study in which participating neurology departments change their practice to test and treat vascular risk factors. Patients are then compared to historic controls using registered data.
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| 2. |
- Robba, Chiara, et al.
(författare)
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Oxygen targets and 6-month outcome after out of hospital cardiac arrest : a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial
- 2022
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 26, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO2) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO2 with patients’ outcome. Methods: Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO2 < 60 mmHg and severe hyperoxemia as PaO2 > 300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results: 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO2-AUC), for hyperoxemia was significantly associated with mortality (p = 0.003). Conclusions: In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration: clinicaltrials.gov NCT02908308, Registered September 20, 2016.
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| 4. |
- Ambrazaitis, Gilbert, 1979-, et al.
(författare)
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Auditory vs. audiovisual prominence ratings of speech involving spontaneously produced head movements
- 2022
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Ingår i: Proceedings of the 11th International Conference on Speech Prosody : Speech Prosody 2022 - Speech Prosody 2022. - : International Speech Communication Association. - 2333-2042. ; , s. 352-356, s. 352-356
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Konferensbidrag (refereegranskat)abstract
- Visual information can be integrated in prominence perception, but most available evidence stems from controlled experimental settings, often involving synthetic stimuli. The present study provides evidence from spontaneously produced head gestures that occurred in Swedish television news readings. Sixteen short clips (containing 218 words in total) were rated for word prominence by 85 adult volunteers in a between-subjects design (44 in an audio-visual vs. 41 in an audio-only condition) using a web-based rating task. As an initial test of overall rating behavior, average prominence across all 218 words was compared between the two conditions, revealing no significant difference. In a second step, we compared normalized prominence ratings between the two conditions for all 218 words individually. These results displayed significant (or near significant, p
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| 5. |
- Ambrazaitis, Gilbert, et al.
(författare)
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F0 Peak Timing, Height, and Shape as Independent Features
- 2014
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Ingår i: Proc. of The 4th International Symposium on Tonal Aspects of Languages, Nijmegen, The Netherlands. - Nijmegen : The International Speech Communication Association (ISCA). ; , s. 138-142, s. 138-142
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Konferensbidrag (refereegranskat)abstract
- A considerable amount of evidence from several intonation languages (e.g., German, English, Italian) supports the idea that F0 peak timing, height, and shape variables form a feature bundle, which is used to encode two-fold intonational (e.g., sentence-level) pitch accent distinctions such as L+H* vs. L*+H. The three types of features in the bundle can be weighted differently but the outcome seems to be functionally equivalent. In this sense, they are ‘substitute phonetic features’. This paper presents data from two distinct prosodic dialect types of Swedish, a pitch-accent language, suggesting that these F0 variables can also be used independently of each other in order to encode two different contrasts (i.e., a three-fold contrast), each of which phonetically and functionally related to the L+H* vs. L*+H distinction in an intonation language. For Central Swedish, we observe two peak raising strategies which go along with differently shaped rises: ‘extending’ (= faster rise) and ‘shifting’ (= slower rise), which tend to be used to signal ‘speaker-related’ emphasis (e.g., ‘surprise’) or ‘messagerelated’ emphasis (e.g., ‘correction’), respectively. For Southern Swedish, we observe an ‘extended’ peak and an ‘extended and delayed’ peak.
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| 8. |
- Ambrazaitis, Gilbert, et al.
(författare)
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The prosody of contrastive topics in Southern Swedish
- 2012
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Ingår i: Proceedings FONETIK 2012 : The XXVth Swedish Phonetics Conference, May 30–June 1, 2012. - Gothenburg : Department of Philosophy, Linguistics and Theory of Science, University of Gothenburg. - 9789163709852 ; , s. 1-4
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper presents a pilot study on the prosodic marking of a contrastive topic in Southern Swedish. A test sentence was elicited in three experimental conditions: initial focus; final focus; contrastive topic (initial word) plus focus (final word). F0 patterns were analysed in recordings of 10 speakers. A majority of the speakers distinguished clearly between the conditions, but speakers employed different strategies. The most common one involved modifying the range and/or level of the F0 patterns given by the lexical pitch accents. Another frequent strategy involved a rising pitch accent on the initial word, where the lexical pitch accent would normally stipulate a fall. This result was unexpected and indicates that Southern Swedish sentence intonation might be more complex than typically assumed.
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| 9. |
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| 10. |
- Ambrazaitis, Gilbert, 1979-, et al.
(författare)
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Word prominence ratings in Swedish television news readings : Effects of pitch accents and head movements
- 2020
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Ingår i: Proceedings of the International Conference on Speech Prosody. - : International Speech Communication Association. - 2333-2042. ; , s. 314-318, s. 314-318
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Konferensbidrag (refereegranskat)abstract
- Prosodic prominence is a multimodal phenomenon where pitch accents are frequently aligned with visible movements by the hands, head, or eyebrows. However, little is known about how such movements function as visible prominence cues in multimodal speech perception with most previous studies being restricted to experimental settings. In this study, we are piloting the acquisition of multimodal prominence ratings for a corpus of natural speech (Swedish television news readings). Sixteen short video clips (218 words) of news readings were extracted from a larger corpus and rated by 44 native Swedish adult volunteers using a web-based set-up. The task was to rate each word in a clip as either non-prominent, moderately prominent or strongly prominent based on audiovisual cues. The corpus was previously annotated for pitch accents and head movements. We found that words realized with a pitch accent and head movement tended to receive higher prominence ratings than words with a pitch accent only. However, we also examined ratings for a number of carefully selected individual words, and these case studies suggest that ratings are affected by complex relations between the presence of a head movement and its type of alignment, the word's F0 profile, and semantic and pragmatic factors.
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