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- Drew, David A., et al.
(författare)
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Aspirin and NSAID use and the risk of COVID-19
- 2021
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Early reports raised concern that use of non-steroidal anti-inflammatory drugs (NSAIDs) may increase risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19). Users of the COVID Symptom Study smartphone application reported use of aspirin and other NSAIDs between March 24 and May 8, 2020. Users were queried daily about symptoms, COVID-19 testing, and healthcare seeking behavior. Cox proportional hazards regression was used to determine the risk of COVID-19 among according to aspirin or non-aspirin NSAID users. Among 2,736,091 individuals in the U.S., U.K., and Sweden, we documented 8,966 incident reports of a positive COVID-19 test over 60,817,043 person-days of follow-up. Compared to non-users and after stratifying by age, sex, country, day of study entry, and race/ethnicity, non-aspirin NSAID use was associated with a modest risk for testing COVID-19 positive (HR 1.23 [1.09, 1.32]), but no significant association was observed among aspirin users (HR 1.13 [0.92, 1.38]). After adjustment for lifestyle factors, comorbidities and baseline symptoms, any NSAID use was not associated with risk (HR 1.02 [0.94, 1.10]). Results were similar for those seeking healthcare for COVID-19 and were not substantially different according to lifestyle and sociodemographic factors or after accounting for propensity to receive testing. Our results do not support an association of NSAID use, including aspirin, with COVID-19 infection. Previous reports of a potential association may be due to higher rates of comorbidities or use of NSAIDs to treat symptoms associated with COVID-19.One Sentence Summary NSAID use is not associated with COVID-19 risk.Competing Interest StatementJW, RD, and JC are employees of Zoe Global Ltd. TDS is a consultant to Zoe Global Ltd. DAD and ATC previously served as investigators on a clinical trial of diet and lifestyle using a separate mobile application that was supported by Zoe Global Ltd. Other authors have no conflict of interest to declare.Clinical TrialNCT04331509Funding StatementZoe provided in kind support for all aspects of building running and supporting the app and service to all users worldwide. DAD is supported by the National Institute of Diabetes and Digestive and Kidney Diseases K01DK120742. CGG is supported by the Bau Tsu Zung Bau Kwan Yeu Hing Research and Clinical Fellowship. LHN is supported by the American Gastroenterological Association Research Scholars Award. ATC is the Stuart and Suzanne Steele MGH Research Scholar and Stand Up to Cancer scientist. The Massachusetts Consortium on Pathogen Readiness (MassCPR) and Mark and Lisa Schwartz supported MGH investigators (DAD CGG LHN ADJ WM RSM CHL SK ATC). CMA is supported by the NIDDK K23 DK120899 and the Boston Childrens Hospital Office of Faculty Development Career Development Award. Kings College of London investigators (KAL MNL TV MSG CHS SO CJS TDS) were supported by the Wellcome Trust and EPSRC (WT212904/Z/18/Z WT203148/Z/16/Z T213038/Z/18/Z) the NIHR GSTT/KCL Biomedical Research Centre MRC/BHF (MR/M016560/1) UK Research and Innovation London Medical Imaging and Artificial Intelligence Centre for Value Based Healthcare and the Alzheimers Society (AS-JF-17-011). MNL is supported by an NIHR Doctoral Fellowship (NIHR300159). Work related to the Swedish elements of the study are supported by grants from the Swedish Research Council, Swedish Heart-Lung Foundation and the Swedish Foundation for Strategic Research (LUDC-IRC 15-0067). Sponsors had no role in study design analysis and interpretation of data report writing and the decision to submit for publication.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Participants provided informed consent to the use of app data for research purposes and agreed to privacy policies and terms of use. This research study was approved by the Partners Human Research Committee IRB 2020P000909 Kings College London Ethics Committee REMAS ID 18210 Review Reference LRS-19/20-18210 and the central ethics committee in Sweden DNR 2020-01803All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesData collected in the app is being shared with other health researchers through the NHS-funded Health Data Research U.K. (HDRUK)/SAIL consortium, housed in the U.K. Secure Research Platform (UKSeRP) in Swansea. Anonymized data is available to be shared with bonafide researchers HDRUK according to their protocols (https://healthdatagateway.org/detail/9b604483-9cdc-41b2-b82c-14ee3dd705f6). U.S. investigators are encouraged to coordinate data requests through the COPE Consortium (www.monganinstitute.org/cope-consortium). Data updates can be found on https://covid.joinzoe.com.
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- Groot, Colin, et al.
(författare)
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Clinical phenotype, atrophy, and small vessel disease in APOEε2 carriers with Alzheimer disease
- 2018
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Ingår i: Neurology. - 1526-632X. ; 91:20, s. 1851-1859
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the clinical phenotype, gray matter atrophy patterns, and small vessel disease in patients who developed prodromal or probable Alzheimer disease dementia, despite carrying the protective APOEε2 allele. METHODS: We included 36 β-amyloid-positive (by CSF or PET) APOEε2 carriers (all ε2/ε3) with mild cognitive impairment or dementia due to Alzheimer disease who were matched for age and diagnosis (ratio 1:2) to APOEε3 homozygotes and APOEε4 carriers (70% ε3/ε4 and 30% ε4/ε4). We assessed neuropsychological performance across 4 cognitive domains (memory, attention, executive, and language functions), performed voxelwise and region of interest analyses of gray matter atrophy on T1-weighted MRI, used fluid-attenuated inversion recovery images to automatically quantify white matter hyperintensity volumes, and assessed T2*-weighted images to identify microbleeds. Differences in cognitive domain scores, atrophy, and white matter hyperintensities between ε2 carriers, ε3 homozygotes, and ε4 carriers were assessed using analysis of variance analyses, and Pearson χ2 tests were used to examine differences in prevalence of microbleeds. RESULTS: We found that ε2 carriers performed worse on nonmemory domains compared to both ε3 homozygotes and ε4 carriers but better on memory compared to ε4 carriers. Voxelwise T1-weighted MRI analyses showed asymmetric (left > right) temporoparietal-predominant atrophy with subtly less involvement of medial-temporal structures in ε2 carriers compared to ε4 carriers. Finally, ε2 carriers had larger total white matter hyperintensity volumes compared to ε4 carriers (mean 10.4 vs 7.3 mL) and a higher prevalence of microbleeds compared to ε3 homozygotes (37.5% vs 18.3%). CONCLUSION: APOEε2 carriers who develop Alzheimer disease despite carrying the protective allele display a nonamnestic clinical phenotype with more severe small vessel disease.
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- Hauptmann, Andreas, et al.
(författare)
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Model-Based Learning for Accelerated, Limited-View 3-D Photoacoustic Tomography
- 2018
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Ingår i: IEEE Transactions on Medical Imaging. - : IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC. - 0278-0062 .- 1558-254X. ; 37:6, s. 1382-1393
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Tidskriftsartikel (refereegranskat)abstract
- Recent advances in deep learning for tomographic reconstructions have shown great potential to create accurate and high quality images with a considerable speed up. In this paper, we present a deep neural network that is specifically designed to provide high resolution 3-D images from restricted photoacoustic measurements. The network is designed to represent an iterative scheme and incorporates gradient information of the data fit to compensate for limited view artifacts. Due to the high complexity of the photoacoustic forward operator, we separate training and computation of the gradient information. A suitable prior for the desired image structures is learned as part of the training. The resulting network is trained and tested on a set of segmented vessels from lung computed tomography scans and then applied to in-vivo photoacoustic measurement data.
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- James, Sarah-Naomi, et al.
(författare)
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A population-based study of head injury, cognitive function and pathological markers.
- 2021
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Ingår i: Annals of clinical and translational neurology. - : Wiley. - 2328-9503. ; 8:4, s. 842-856
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Tidskriftsartikel (refereegranskat)abstract
- To assess associations between head injury (HI) with loss of consciousness (LOC), ageing and markers of later-life cerebral pathology; and to explore whether those effects may help explain subtle cognitive deficits in dementia-free individuals.Participants (n = 502, age = 69-71) from the 1946 British Birth Cohort underwent cognitive testing (subtests of Preclinical Alzheimer Cognitive Composite), 18 F-florbetapir Aβ-PET and MR imaging. Measures include Aβ-PET status, brain, hippocampal and white matter hyperintensity (WMH) volumes, normal appearing white matter (NAWM) microstructure, Alzheimer's disease (AD)-related cortical thickness, and serum neurofilament light chain (NFL). LOC HI metrics include HI occurring: (i) >15 years prior to the scan (ii) anytime up to age 71.Compared to those with no evidence of an LOC HI, only those reporting an LOC HI>15 years prior (16%, n = 80) performed worse on cognitive tests at age 69-71, taking into account premorbid cognition, particularly on the digit-symbol substitution test (DSST). Smaller brain volume (BV) and adverse NAWM microstructural integrity explained 30% and 16% of the relationship between HI and DSST, respectively. We found no evidence that LOC HI was associated with Aβ load, hippocampal volume, WMH volume, AD-related cortical thickness or NFL (all p > 0.01).Having a LOC HI aged 50's and younger was linked with lower later-life cognitive function at age ~70 than expected. This may reflect a damaging but small impact of HI; explained in part by smaller BV and different microstructure pathways but not via pathology related to AD (amyloid, hippocampal volume, AD cortical thickness) or ongoing neurodegeneration (serum NFL).
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- Kennedy, Beatrice, 1982-, et al.
(författare)
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App-based COVID-19 syndromic surveillance and prediction of hospital admissions in COVID Symptom Study Sweden
- 2022
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- The app-based COVID Symptom Study was launched in Sweden in April 2020 to contribute to real-time COVID-19 surveillance. We enrolled 143,531 study participants (≥18 years) who contributed 10.6 million daily symptom reports between April 29, 2020 and February 10, 2021. Here, we include data from 19,161 self-reported PCR tests to create a symptom-based model to estimate the individual probability of symptomatic COVID-19, with an AUC of 0.78 (95% CI 0.74-0.83) in an external dataset. These individual probabilities are employed to estimate daily regional COVID-19 prevalence, which are in turn used together with current hospital data to predict next week COVID-19 hospital admissions. We show that this hospital prediction model demonstrates a lower median absolute percentage error (MdAPE: 25.9%) across the five most populated regions in Sweden during the first pandemic wave than a model based on case notifications (MdAPE: 30.3%). During the second wave, the error rates are similar. When we apply the same model to an English dataset, not including local COVID-19 test data, we observe MdAPEs of 22.3% and 19.0% during the first and second pandemic waves, respectively, highlighting the transferability of the prediction model.
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| 10. |
- Landgren, Matilda, et al.
(författare)
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Segmentation of the Left Heart Ventricle in Ultrasound Images Using a Region Based Snake
- 2013
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Ingår i: Medical Imaging 2013: Image Processing. - : SPIE. - 1996-756X .- 0277-786X. - 9780819494436 ; 8669
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Konferensbidrag (refereegranskat)abstract
- Ultrasound imaging of the heart is a non-invasive method widely used for different applications. One of them is to measure the blood volume in the left ventricle at different stages of the heart cycle. This demands a proper segmentation of the left ventricle and a (semi-) automated method would decrease intra-variability as well as workload. This paper presents a semi-automated segmentation method that uses a region based snake. To avoid any unwanted concavities in the segmentations due to the cardiac valve we use two anchor points in the snake that are located to the left and to the right of the cardiac valve respectively. For the possibility of segmentations in different stages of the heart cycle these anchor points are tracked through the cycle. This tracking is based both on the resemblance of a region around the anchor points and a prior model of the movement in the y-direction of the anchor points. The region based snake functional is the sum of two terms, a regularizing term and a data term. It is our data term that is region based since it involves the integration of a two-dimensional subdomain of the image plane. A segmentation of the left ventricle is obtained by minimizing the functional which is done by continuously reshaping the contour until the optimal shape and size is obtained. The developed method shows promising results.
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