| 1. |
- Nielsen, Niklas, et al.
(författare)
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Target temperature management after out-of-hospital cardiac arrest-a randomized, parallel-group, assessor-blinded clinical trial-rationale and design
- 2012
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Ingår i: American Heart Journal. - : Elsevier. - 0002-8703 .- 1097-6744. ; 163:4, s. 541-548
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Tidskriftsartikel (refereegranskat)abstract
- Background Experimental animal studies and previous randomized trials suggest an improvement in mortality and neurologic function with induced hypothermia after cardiac arrest. International guidelines advocate the use of a target temperature management of 32 degrees C to 34 degrees C for 12 to 24 hours after resuscitation from out-of-hospital cardiac arrest. A systematic review indicates that the evidence for recommending this intervention is inconclusive, and the GRADE level of evidence is low. Previous trials were small, with high risk of bias, evaluated select populations, and did not treat hyperthermia in the control groups. The optimal target temperature management strategy is not known. less thanbrgreater than less thanbrgreater thanMethods The TTM trial is an investigator-initiated, international, randomized, parallel-group, and assessor-blinded clinical trial designed to enroll at least 850 adult, unconscious patients resuscitated after out-of-hospital cardiac arrest of a presumed cardiac cause. The patients will be randomized to a target temperature management of either 33 degrees C or 36 degrees C after return of spontaneous circulation. In both groups, the intervention will last 36 hours. The primary outcome is all-cause mortality at maximal follow-up. The main secondary outcomes are the composite outcome of all-cause mortality and poor neurologic function (cerebral performance categories 3 and 4) at hospital discharge and at 180 days, cognitive status and quality of life at 180 days, assessment of safety and harm. less thanbrgreater than less thanbrgreater thanDiscussion The TTM trial will investigate potential benefit and harm of 2 target temperature strategies, both avoiding hyperthermia in a large proportion of the out-of-hospital cardiac arrest population.
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| 2. |
- Adolphi, Florian, et al.
(författare)
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Persistent link between solar activity and Greenland climate during the Last Glacial Maximum
- 2014
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Ingår i: Nature Geoscience. - 1752-0908 .- 1752-0894. ; 7:9, s. 662-666
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Tidskriftsartikel (refereegranskat)abstract
- Changes in solar activity have previously been proposed to cause decadal- to millennial-scale fluctuations in both the modern and Holocene climates(1). Direct observational records of solar activity, such as sunspot numbers, exist for only the past few hundred years, so solar variability for earlier periods is typically reconstructed from measurements of cosmogenic radionuclides such as Be-10 and C-14 from ice cores and tree rings(2,3). Here we present a high-resolution Be-10 record from the ice core collected from central Greenland by the Greenland Ice Core Project (GRIP). The record spans from 22,500 to 10,000 years ago, and is based on new and compiled data(4-6). Using C-14 records(7,8) to control for climate-related influences on Be-10 deposition, we reconstruct centennial changes in solar activity. We find that during the Last Glacial Maximum, solar minima correlate with more negative delta O-18 values of ice and are accompanied by increased snow accumulation and sea-salt input over central Greenland. We suggest that solar minima could have induced changes in the stratosphere that favour the development of high-pressure blocking systems located to the south of Greenland, as has been found in observations and model simulations for recent climate(9,10). We conclude that the mechanism behind solar forcing of regional climate change may have been similar under both modern and Last Glacial Maximum climate conditions.
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| 3. |
- Baturova, Maria A., et al.
(författare)
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Atrial fibrillation as a clinical characteristic of arrhythmogenic right ventricular cardiomyopathy : Experience from the Nordic ARVC Registry
- 2020
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 298, s. 39-43
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent studies in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients have drawn attention to atrial fibrillation (AF) as an arrhythmic manifestation of ARVC and as an indicator of atrial involvement in the disease progression. We aimed to assess the prevalence of AF in the Scandinavian cohort of ARVC patients and to evaluate its association with disease clinical manifestations. Methods: Study sample comprised of 293 definite ARVC patients by 2010 Task Force criteria (TFC2010) and 141 genotype-positive family members (total n = 434, 43% females, median age at ARVC diagnosis 41 years [interquartile range (IQR) 28–52 years]). ARVC diagnostic score was calculated as the sum of major (2 points) and minor (1 point) criteria in all categories of the TFC2010. Results: AF was diagnosed in 42 patients (10%): in 41 patients with definite ARVC diagnosis (14%) vs in one genotype-positive family member (1%), p < 0.001. The median age at AF onset was 51 (IQR 38–58) years. The prevalence of AF was related to the ARVC diagnostic score: it significantly increased starting with the diagnostic score 4 (2% in those with score 3 vs 13% in those with score 4, p = 0.023) and increased further with increased diagnostic score (Somer's d value is 0.074, p < 0.001). Conclusion: AF is seen in 14% of definite ARVC patients and is related to the severity of disease phenotype thus suggesting AF being an arrhythmic manifestation of this cardiomyopathy indicating atrial myocardial involvement in the disease progression.
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| 4. |
- Baturova, Maria A., et al.
(författare)
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Evolution of P-wave indices during long-term follow-up as markers of atrial substrate progression in arrhythmogenic right ventricular cardiomyopathy
- 2021
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Ingår i: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 23:Supplement_1, s. i29-i37
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) have increased prevalence of atrial arrhythmias indicating atrial involvement in the disease. We aimed to assess the long-term evolution of P-wave indices as electrocardiographic (ECG) markers of atrial substrate during ARVC progression.METHODS AND RESULTS: We included 100 patients with a definite ARVC diagnosis according to 2010 Task Force criteria [34% females, median age 41 (inter-quartile range 30-55) years]. All available sinus rhythm ECGs (n = 1504) were extracted from the regional electronic ECG databases and automatically processed using Glasgow algorithm. P-wave duration, P-wave area, P-wave frontal axis, and prevalence of abnormal P terminal force in lead V1 (aPTF-V1) were assessed and compared at ARVC diagnosis, 10 years before and up to 15 years after diagnosis.Prior to ARVC diagnosis, none of the P-wave indices differed significantly from the data at ARVC diagnosis. After ascertainment of ARVC diagnosis, P-wave area in lead V1 decreased from -1 to -30 µV ms at 5 years (P = 0.002). P-wave area in lead V2 decreased from 82 µV ms at ARVC diagnosis to 42 µV ms 10 years after ARVC diagnosis (P = 0.006). The prevalence of aPTF-V1 increased from 5% at ARVC diagnosis to 18% by the 15th year of follow-up (P = 0.004). P-wave duration and frontal axis did not change during disease progression.CONCLUSION: Initial ARVC progression was associated with P-wave flattening in right precordial leads and in later disease stages an increased prevalence of aPTF-V1 was seen.
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| 5. |
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| 6. |
- Braun, Oscar, et al.
(författare)
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Concomitant use of warfarin and ticagrelor as an alternative to triple antithrombotic therapy after an acute coronary syndrome.
- 2015
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Ingår i: Thrombosis Research. - : Elsevier BV. - 1879-2472 .- 0049-3848. ; 135:1, s. 26-30
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Tidskriftsartikel (refereegranskat)abstract
- Treatment with warfarin in combination with clopidogrel has been shown to reduce the incidence of major bleeding as compared to triple antithrombotic therapy (TT; warfarin, clopidogrel and aspirin). However, there are uncertainties regarding the risk for thrombosis since poor-responsiveness to clopidogrel is common. Ticagrelor is a more potent platelet inhibitor, but data supporting concurrent use of ticagrelor and warfarin (dual antithrombotic therapy, DT) is limited. This study therefore sought to evaluate the risk of bleeding and thrombosis associated with DT after an acute coronary syndrome (ACS).
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| 7. |
- Brehm, Stefan, et al.
(författare)
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A fragmented environmental state? Analysing spatial compliance patterns for the case of transparency legislation in China
- 2017
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Ingår i: Asia-Pacific Journal of Regional Science. - : Springer Science and Business Media LLC. - 2509-7946 .- 2509-7954. ; 1:2, s. 471-493
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Tidskriftsartikel (refereegranskat)abstract
- Do Chinese cities compete for investments with lax environmental law enforcement? The here presented study suggests that this is true for some municipalities but not all of them. Based on data for 126 key environmental protection cities and regional economic hubs between 2010 and 2012 we show that economic decentralization and political centralization both shape spatial patterns of compliance with environmental transparency legislation. Our results give reason to suppose that the Chinese economy moved beyond homogenous preferences for low-cost regulatory arrangements. The emerging jurisdictional interaction is in line with a Tiebout sorting process, where cities compete with diverse factor packages to attract an optimal amount of investments.
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| 8. |
- Brehm, Stefan, et al.
(författare)
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Are Model Cities an Effective Instrument for Urban Environmental Governance?
- 2019
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Ingår i: Greening China's Urban Governance : Tackling Environmental and Sustainability Challenges - Tackling Environmental and Sustainability Challenges. - Singapore : Springer Nature Singapore. - 2367-1068 .- 2367-105X. - 9789811307393 - 9789811307409 ; 7, s. 25-49
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Bokkapitel (refereegranskat)abstract
- Since the 1980s, China’s central government has created various model and incentive schemes aimed at systematically and concurrently promoting innovative approaches for protecting the urban ecological environment. In this context, programmes such as the ‘model city for protecting the environment’, ‘garden city’, ‘eco-city’, or ‘low-carbon city’ have become an integral part of China’s system for urban environmental governance. However, the role of these policy-incentive schemes for promoting best practice is only partly understood. This chapter contributes to the literature with a conceptualization of model cities as a dynamic governance instrument. The analysis suggests that the distance between programme objectives and local practices increases with programme maturity. Model-city schemes inevitably reach a point of saturation once a competing programme provides new opportunities to gain political and economic rents.
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| 9. |
- Brehm, Stefan, et al.
(författare)
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Environmental governance with Chinese characteristics : are environmental model cities a good example for other municipalities?
- 2020
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Ingår i: Asia-Pacific Journal of Regional Science. - : Springer Science and Business Media LLC. - 2509-7946 .- 2509-7954. ; 4, s. 111-134
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Tidskriftsartikel (refereegranskat)abstract
- Model programs such as the ‘environmental protection model city’ have become an inherent part of China’s urban environmental governance. The role of these incentive schemes for promoting best practice, however, has been neglected so far. In this study, we show that model city programs raise the bar in terms of environmental standards. What is more, model cities have a positive impact on regional economic development. We deploy a spatial Durbin model to measure best practice diffusion among 126 key environmental protection cities between 2009 and 2012. The results suggest that environmental model cities are better performers on average. We also find evidence for a positive spillover effect. Diffusion patterns are multi-layered where economic proximity is the most important dimension, followed by physical colocation and administrative hierarchy.
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| 10. |
- Christensen, Alex Hørby, et al.
(författare)
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Complications of implantable cardioverter-defibrillator treatment in arrhythmogenic right ventricular cardiomyopathy
- 2022
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Ingår i: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 24:2, s. 306-312
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Treatment with implantable cardioverter-defibrillators (ICD) is a cornerstone for prevention of sudden cardiac death in arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed at describing the complications associated with ICD treatment in a multinational cohort with long-term follow-up. Methods and results: The Nordic ARVC registry was established in 2010 and encompasses a large multinational cohort of ARVC patients, including their clinical characteristics, treatment, and events during follow-up. We included 299 patients (66% males, median age 41 years). During a median follow-up of 10.6 years, 124 (41%) patients experienced appropriate ICD shock therapy, 28 (9%) experienced inappropriate shocks, 82 (27%) had a complication requiring surgery (mainly lead-related, n = 75), and 99 (33%) patients experienced the combined endpoint of either an inappropriate shock or a surgical complication. The crude rate of first inappropriate shock was 3.4% during the first year after implantation but decreased after the first year and plateaued over time. Contrary, the risk of a complication requiring surgery was 5.5% the first year and remained high throughout the study period. The combined risk of any complication was 7.9% the first year. In multivariate cox regression, presence of atrial fibrillation/flutter was a risk factor for inappropriate shock (P < 0.05), whereas sex, age at implant, and device type were not (all P > 0.05). Conclusion: Forty-one percent of ARVC patients treated with ICD experienced potentially life-saving ICD therapy during long-term follow-up. A third of the patients experienced a complication during follow-up with lead-related complications constituting the vast majority.
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