| 1. |
- Engström, Gunnar, et al.
(author)
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Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
- 2024
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In: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
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Journal article (peer-reviewed)abstract
- Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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| 2. |
- Bergström, Göran, 1964, et al.
(author)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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In: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Journal article (peer-reviewed)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 3. |
- Engström, Gunnar, et al.
(author)
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The Swedish CArdioPulmonary BioImage Study : objectives and design
- 2015
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In: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 278:6, s. 645-659
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Journal article (peer-reviewed)abstract
- Cardiopulmonary diseases are major causes of death worldwide, but currently recommended strategies for diagnosis and prevention may be outdated because of recent changes in risk factor patterns. The Swedish CArdioPulmonarybioImage Study (SCAPIS) combines the use of new imaging technologies, advances in large-scale 'omics' and epidemiological analyses to extensively characterize a Swedish cohort of 30 000 men and women aged between 50 and 64 years. The information obtained will be used to improve risk prediction of cardiopulmonary diseases and optimize the ability to study disease mechanisms. A comprehensive pilot study in 1111 individuals, which was completed in 2012, demonstrated the feasibility and financial and ethical consequences of SCAPIS. Recruitment to the national, multicentre study has recently started.
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| 4. |
- Oldgren, Jonas, 1964-, et al.
(author)
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Systematic Coronary Risk Evaluation estimated risk and prevalent subclinical atherosclerosis in coronary and carotid arteries: A population-based cohort analysis from the Swedish Cardiopulmonary Bioimage Study
- 2021
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In: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 28:3, s. 250-259
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Journal article (peer-reviewed)abstract
- Background It is not clear if the European Systematic Coronary Risk Evaluation algorithm is useful for identifying prevalent subclinical atherosclerosis in a population of apparently healthy individuals. Our aim was to explore the association between the risk estimates from Systematic Coronary Risk Evaluation and prevalent subclinical atherosclerosis. Design The design of this study was as a cross-sectional analysis from a population-based study cohort. Methods From the general population, the Swedish Cardiopulmonary Bioimage Study randomly invited individuals aged 50-64 years and enrolled 13,411 participants mean age 57 (standard deviation 4.3) years; 46% males between November 2013-December 2016. Associations between Systematic Coronary Risk Evaluation risk estimates and coronary artery calcification and plaques in the carotid arteries by using imaging data from a computed tomography of the heart and ultrasonography of the carotid arteries were examined. Results Coronary calcification was present in 39.5% and carotid plaque in 56.0%. In men, coronary artery calcium score >0 ranged from 40.7-65.9% and presence of carotid plaques from 54.5% to 72.8% in the age group 50-54 and 60-65 years, respectively. In women, the corresponding difference was from 17.1-38.9% and from 41.0-58.4%. A doubling of Systematic Coronary Risk Evaluation was associated with an increased probability to have coronary artery calcium score >0 (odds ratio: 2.18 (95% confidence interval 2.07-2.30)) and to have >1 carotid plaques (1.67 (1.61-1.74)). Conclusion Systematic Coronary Risk Evaluation estimated risk is associated with prevalent subclinical atherosclerosis in two major vascular beds in a general population sample without established cardiovascular disease or diabetes mellitus. Thus, the Systematic Coronary Risk Evaluation risk chart may be of use for estimating the risk of subclinical atherosclerosis.
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| 5. |
- Bergström, Göran, 1964, et al.
(author)
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Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
- 2023
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In: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
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Journal article (peer-reviewed)abstract
- Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p < 0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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| 6. |
- Hagstrom, Emil, et al.
(author)
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IMPACT OF BODY WEIGHT AT AGE 20 AND WEIGHT GAIN DURING ADULTHOOD ON MIDLIFE CORONARY ARTERY CALCIUM IN 15,000 MEN AND WOMEN : AN INTERIM ANALYSIS OF THE SWEDISH CARDIOPULMONARY BIOIMAGE STUDY
- 2019
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In: Journal of the American College of Cardiology. - : ELSEVIER SCIENCE INC. - 0735-1097 .- 1558-3597. ; 73:9, s. 1692-1692
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Journal article (other academic/artistic)abstract
- BackgroundElevated body weight in adolescence is strongly associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, or to weight gain with subsequent high adult weight is not known. Using data from the Swedish CArdioPulmonary bioImage Study (SCAPIS), we investigated the association between weight at age 20, weight gain to midlife and coronary artery calcium score (CACS) at midlife.MethodsIn the first 15,810 participants in SCAPIS (mean age 58 years, 52% women), data on CACS at midlife, self-reported body weight at age 20 and weight at examination in SCAPIS were recorded.ResultsCACS in midlife was significantly higher with increasing weight at age 20 (p<0.001 for both sexes), and then increased with weight gain until midlife at all levels of body weight at age 20 after adjusting for age, height, smoking, alcohol intake, education level, exercise levels and LDL cholesterol. However, the association with weight gain was only significant in men (p = 0.047), not in women (p=0.474). No significant interaction was seen between weight at age 20 and midlife weight with CACS. The effect of weight at age 20 on CACS was significantly more marked in men than in women, as was the effect of weight gain (p<0.001 for both interactions).ConclusionWeight at age 20 and weight gain to midlife were both related to CACS, but much more markedly so in men than in women, indicating a generally larger effect of both early adult weight and further weight gain until midlife on CACS in men, compared to women.
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| 7. |
- Berntsson, Thore, 1947, et al.
(author)
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Towards Sustainabel Oil Refinery - Pre-study for larger co-operation project
- 2008
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Reports (other academic/artistic)abstract
- In this report, the Chalmers EnergiCentrum (CEC) presents the results of a pre-study commissioned by Preem relating to the effective production of future vehicle fuels.This pre-study was made up of three studies focusing on energy streamlining, the utilisation of waste heat and carbon-dioxide separation and biorefinement relating to the gasification and hydration of vegetable oils. One of the common starting points for these studies was the current situation at the Preem refineries in Göteborg and Lysekil from where the measurement data were obtained and analysed. The report summarises the knowledge situation based on current research in the individual technical fields. The results present some interesting future opportunities for developing the sustainable production of future vehicle fuels. The sections vary, as the areas that have been examined differ and the sections have been written by different people. The reports ends with some joint conclusions and a number of questions which could be included and answered in a more extensive future main study, as part of a developed research partnership between Preem and the Chalmers University of Technology. The preliminary results of this work were analysed with the client at workshops on 1 October and 29 November 2007. The report is written in English combined with an extensive summary in Swedish including a proposal on a future main study. The study was conducted by the Chalmers EnergiCentrum (CEC), in collaboration with a number of researchers in the CEC’s network. They included Thore Berntsson, Jessica Algehed, Erik Hektor and Lennart Persson Elmeroth, all from Heat and Power Technology, Börje Gevert, Chemical and Biological Engineering, Tobias Richards, Forest Products and Chemical Engineering, Filip Johnsson and Anders Lyngfelt, Energy Technology, and Per-Åke Franck and Anders Åsblad, CIT Industriell Energianalys AB. The client, Preem, was represented by Bengt Ahlén, Sören Eriksson, Johan Jervehed, Bertil Karlsson, Gunnar Olsson, Ulf Kuylenstierna, Stefan Nyström, Martin Sjöberg and Thomas Ögren. Tobias Richards was responsible for compiling the report and Bertil Pettersson was the project manager.
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| 8. |
- Borsgård, Gustav, 1984-
(author)
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Litteraturens mått : politiska implikationer av litteraturundervisning som demokrati- och värdegrundsarbete
- 2021
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Doctoral thesis (other academic/artistic)abstract
- Avhandlingens syfte är att undersöka politiska implikationer av idén om litteraturundervisning som demokrati- och värdegrundsarbete i förhållande till det ideal om mätbar kunskap som präglar samtidens utbildningspolicydiskurser. Det som står i fokus är 2011 års gymnasiereform, som tolkas mot bakgrund av en genomgripande förändring av den globala och europeiska utbildningspolicydiskursen från och med millennieskiftet. Avhandlingen undersöker hur subjekt, samhälle och relationen däremellan förstås av aktörer inom policy, forskning och av lärare. Analysen är uppdelad i en transnationell nivå, en nationell nivå och en didaktisk nivå. Avhandlingen visar också hur policydiskurser rekontextualiseras mellan de olika nivåerna.Vad gäller den transnationella nivån visar avhandlingen hur EU:s utbildningspolicy lägger stor vikt vid utbildningens samhällsekonomiska funktion samtidigt som demokratiska aspekter av utbildning tonas ned. EU framhäver även värdet av entreprenörskap och kopplar kreativitetsfrämjande aspekter av konst och humaniora till arbetsmarknaden och ekonomisk tillväxt. I ramverket till OECD:s PISA-studier lyfts reading literacy fram som viktigt för såväl kritiskt tänkande som ekonomisk utveckling. Läsningen av skönlitteratur specifikt definieras dock som en individuell angelägenhet och fritidsaktivitet. Genom att anlägga ett psykologiskt perspektiv på skönlitteraturen och lyfta fram den som en individuell – snarare än samhällelig eller strukturell – angelägenhet sker en av avpolitisering av litteraturläsningens emancipatoriska värde.Vad gäller den nationella nivån visar avhandlingen hur skolans syn på demokrati och litteratur har genomgått förändringar sedan 1940-talet. Framför allt har demokratin gradvis kommit att förstås som ett ”fullbordat” projekt, snarare än som någonting som kan utvecklas eller fördjupas. Med hjälp av Gert Biestas tre dimensioner av medborgarfostran gör avhandlingen en kritisk genomgång av tongivande teorier om litteraturundervisning som demokrati- och värdegrundsarbete, och argumenterar för att merparten av teorierna fokuserar på medborgarfostran som socialisering snarare än subjektivering. Med andra ord innebär demokratiarbetet en anpassning till, snarare än en kritik av, det omgivande samhället. Avhandlingen använder sig också av Peter Dahler-Larsens begrepp konstitutiva effekter för att visa hur 2011 års gymnasiereform tonade ned demokratiska aspekter av litteraturundervisning i förhållande till den föregående läroplanen.Vad gäller den didaktiska nivån använder sig avhandlingen av kvalitativa lärarintervjuer som visar hur lärares didaktiska val ramas in av styrdokumenten och olika administrativa uppgifter. Avhandlingen argumenterar för att lärarnas tolkning av styrdokumenten innebär ett rekontextualiseringsfält inom vilket lärarna förhandlar med läroplanens bestämmelser. I flera fall väljer lärarna att bortse från aspekter av styrdokumenten för att i stället grunda sina didaktiska val på den egna lärarerfarenheten. Det avslutande kapitlet argumenterar för att en viktig politisk implikation av idén om litteraturundervisning som demokrati- och värdegrundsarbete – i synnerhet när den kombineras med strävan efter mätbarhet – är att utbildningens subjektiveringsdimension marginaliseras. Avhandlingen argumenterar för att utbildning skulle kunna handla mindre om fastslagna värden och mätbara kompetenser, och mer om elevers behov av att lära sig hantera icke-vetande.
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| 9. |
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| 10. |
- Gupta, Vikas, et al.
(author)
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Automated three-dimensional tracking of the left ventricular myocardium in time-resolved and dose-modulated cardiac CT images using deformable image registration
- 2018
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In: Journal of Cardiovascular Computed Tomography. - : Elsevier. - 1934-5925. ; 12:2, s. 139-148
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Journal article (peer-reviewed)abstract
- Background Assessment of myocardial deformation from time-resolved cardiac computed tomography (4D CT) would augment the already available functional information from such an examination without incurring any additional costs. A deformable image registration (DIR) based approach is proposed to allow fast and automatic myocardial tracking in clinical 4D CT images.Methods Left ventricular myocardial tissue displacement through a cardiac cycle was tracked using a B-spline transformation based DIR. Gradient of such displacements allowed Lagrangian strain estimation with respect to end-diastole in clinical 4D CT data from ten subjects with suspected coronary artery disease. Dice similarity coefficient (DSC), point-to-curve error (PTC), and tracking error were used to assess the tracking accuracy. Wilcoxon signed rank test provided significance of tracking errors. Topology preservation was verified using Jacobian of the deformation. Reliability of estimated strains and torsion (normalized twist angle) was tested in subjects with normal function by comparing them with normal strain in the literature.Results Comparison with manual tracking showed high accuracy (DSC: 0.99± 0.05; PTC: 0.56mm± 0.47 mm) and resulted in determinant(Jacobian) > 0 for all subjects, indicating preservation of topology. Average radial (0.13 mm), angular (0.64) and longitudinal (0.10 mm) tracking errors for the entire cohort were not significant (p > 0.9). For patients with normal function, average strain [circumferential, radial, longitudinal] and peak torsion estimates were: [-23.5%, 31.1%, −17.2%] and 7.22°, respectively. These estimates were in conformity with the reported normal ranges in the existing literature.Conclusions Accurate wall deformation tracking and subsequent strain estimation are feasible with the proposed method using only routine time-resolved 3D cardiac CT.
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