| 1. |
- Bergström, Göran, 1964, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
Tidskriftsartikel (refereegranskat)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.
|
|
| 2. |
- Bergström, Göran, et al.
(författare)
-
Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
-
Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
-
Tidskriftsartikel (refereegranskat)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.
|
|
| 3. |
- Mohammad, Moman A., et al.
(författare)
-
Incidence and outcome of myocardial infarction treated with percutaneous coronary intervention during COVID-19 pandemic
- 2020
-
Ingår i: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 106:23, s. 1812-1818
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Most reports on the declining incidence of myocardial infarction (MI) during the COVID-19 have either been anecdotal, survey results or geographically limited to areas with lockdowns. We examined the incidence of MI during the COVID-19 pandemic in Sweden, which has remained an open society with a different public health approach fighting COVID-19.METHODS: We assessed the incidence rate (IR) as well as the incidence rate ratios (IRRs) of all MI referred for coronary angiography in Sweden using the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR), during the COVID-19 pandemic in Sweden (1 March 2020-7 May 2020) in relation to the same days 2015-2019.RESULTS: A total of 2443 MIs were referred for coronary angiography during the COVID-19 pandemic resulting in an IR 36 MIs/day (204 MIs/100 000 per year) compared with 15 213 MIs during the reference period with an IR of 45 MIs/day (254 MIs/100 000 per year) resulting in IRR of 0.80, 95% CI (0.74 to 0.86), p<0.001. Results were consistent in all investigated patient subgroups, indicating no change in patient category seeking cardiac care. Kaplan-Meier event rates for 7-day case fatality were 439 (2.3%) compared with 37 (2.9%) (HR: 0.81, 95% CI (0.58 to 1.13), p=0.21). Time to percutaneous coronary intervention (PCI) was shorter during the pandemic and PCI was equally performed, indicating no change in quality of care during the pandemic.CONCLUSION: The COVID-19 pandemic has significantly reduced the incidence of MI referred for invasive treatment strategy. No differences in overall short-term case fatality or quality of care indicators were observed.
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Bäckström, Martin, et al.
(författare)
-
Five-factor personality inventories have a competence-related higher-order factor due to item phrasing
- 2020
-
Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078.
-
Tidskriftsartikel (refereegranskat)abstract
- This research examines whether the items of some of the most well-established five-factor inventories refer to competence. Results reveal that both experts and laymen can distinguish between items that refer to how competently a behavior is performed and items that do not (Study 1). Responses to items that refer to competence create a higher-order factor in the personality inventories (Study 2), and the variability in responses to competence-related items in personality self-ratings is best modeled as a general factor rather than as also tied to the specific Big Five factors (Studies 3 and 4). We suggest that a focused debate on what personality items should refer to is likely to have considerable positive consequences for both theory and measurement of personality.
|
|
| 7. |
- Eguizabal, Alma, et al.
(författare)
-
A deep learning post-processing to enhance the maximum likelihood estimate of three material decomposition in photon counting spectral CT
- 2021
-
Ingår i: Proceedings of SPIE. - : SPIE-Intl Soc Optical Eng.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Photon counting detectors in x-ray computed tomography (CT) improve the decomposition of the CT scans into different materials. This decomposition is however not straightforward to solve, both in terms of computation expense and Photon counting detectors in x-ray computed tomography (CT) are a major technological advancement that provides additional energy information, and improve the decomposition of the CT image into material images. This material decomposition problem is however a non-linear inverse problem that is difficult to solve, both in terms of computation expense and accuracy. The most accepted solution consists in defining an optimization problem based on a maximum likelihood (ML) estimate with Poisson statistics, which is a model-based approach very dependent on the considered forward model and the chosen optimization solver. This may make the material decomposition result noisy and slow to be computed. To incorporate data-driven enhancement to the ML estimate, we propose a deep learning post-processing technique. Our approach is based on convolutional residual blocks that mimic the updates of an iterative optimization process and consider the ML estimate as an input. Therefore, our architecture implicitly considers the physical models of the problem, and in consequence needs less training data and fewer parameters than other standard convolutional networks typically used in medical imaging. We have studied a simulation case of our deep learning post-processing, first on a set of 350 Shepp-Logan -based phantoms, and then in a 600 human numerical phantoms. Our approach has shown denoising enhancement over two different ray-wise decomposition methods: one based on a Newton’s method to solve the ML estimation, and one based on a linear least-squares approximation of the ML expression. We believe this new deep learning post-processing approach is a promising technique to denoise material-decomposed sinograms in photon-counting CT.
|
|
| 8. |
- Ekström, Erik, et al.
(författare)
-
The effects of microstructure, Nb content and secondary Ruddlesden-Popper phase on thermoelectric properties in perovskite CaMn1-xNbxO3 (x=0-0.10) thin films
- 2020
-
Ingår i: RSC Advances. - : Royal Society of Chemistry. - 2046-2069. ; 10:13, s. 7918-7926
-
Tidskriftsartikel (refereegranskat)abstract
- CaMn1-xNbxO3 (x = 0, 0.5, 0.6, 0.7 and 0.10) thin films have been grown by a two-step sputtering/annealing method. First, rock-salt-structured (Ca,Mn1-x,Nb-x)O thin films were deposited on 11 & x304;00 sapphire using reactive RF magnetron co-sputtering from elemental targets of Ca, Mn and Nb. The CaMn1-xNbxO3 films were then obtained by thermally induced phase transformation from rock-salt-structured (Ca,Mn1-xNbx)O to orthorhombic during post-deposition annealing at 700 degrees C for 3 h in oxygen flow. The X-ray diffraction patterns of pure CaMnO3 showed mixed orientation, while Nb-containing films were epitaxially grown in [101] out of-plane-direction. Scanning transmission electron microscopy showed a Ruddlesden-Popper (R-P) secondary phase in the films, which results in reduction of the electrical and thermal conductivity of CaMn1-xNbxO3. The electrical resistivity and Seebeck coefficient of the pure CaMnO3 film were measured to 2.7 omega cm and -270 mu V K-1 at room temperature, respectively. The electrical resistivity and Seebeck coefficient were reduced by alloying with Nb and was measured to 0.09 omega cm and -145 mu V K-1 for x = 0.05. Yielding a power factor of 21.5 mu W K-2 m(-1) near room temperature, nearly eight times higher than for pure CaMnO3 (2.8 mu W K-2 m(-1)). The power factors for alloyed samples are low compared to other studies on phase-pure material. This is due to high electrical resistivity originating from the secondary R-P phase. The thermal conductivity of the CaMn1-xNbxO3 films is low for all samples and is the lowest for x = 0.07 and 0.10, determined to 1.6 W m(-1) K-1. The low thermal conductivity is attributed to grain boundary scattering and the secondary R-P phase.
|
|
| 9. |
- Fröbert, Ole, 1964-, et al.
(författare)
-
Influenza Vaccination after Myocardial Infarction : A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial
- 2021
-
Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 144:18, s. 1476-1484
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Observational and small randomized studies suggest that influenza vaccine may reduce future cardiovascular events in patients with cardiovascular disease.Methods: We conducted an investigator-initiated, randomized, double-blind trial to compare inactivated influenza vaccine with saline placebo administered shortly after myocardial infarction (MI) (99.7% of patients) or high-risk stable coronary heart disease (0.3%). The primary endpoint was the composite of all-cause death, MI, or stent thrombosis at 12 months. A hierarchical testing strategy was used for the key secondary endpoints: all-cause death, cardiovascular death, MI, and stent thrombosis.Results: Due to the Covid-19 pandemic, the data safety and monitoring board decided to halt the trial before attaining the prespecified sample size. Between October 1, 2016, and March 1, 2020, 2571 participants were randomized at 30 centers across eight countries; 1290 assigned to influenza vaccine and 1281 to placebo. Over the 12-month follow-up, the primary outcome occurred in 67 participants (5.3%) assigned influenza vaccine and 91 participants (7.2%) assigned placebo (hazard ratio, 0.72; 95% confidence interval, 0.52 to 0.99; P=0.040). Rates of all-cause death were 2.9% and 4.9% (hazard ratio, 0.59; 0.39 to 0.89; P=0.010), of cardiovascular death 2.7% and 4.5%, (hazard ratio, 0.59; 0.39 to 0.90; P=0.014), and of MI 2.0% and 2.4% (hazard ratio, 0.86; 0.50 to 1.46, P=0.57) in the influenza vaccine and placebo groups, respectively. Conclusions: Influenza vaccination early after an MI or in high-risk coronary heart disease resulted in a lower risk of a composite of all-cause death, MI, or stent thrombosis, as well as a lower risk of all-cause death and cardiovascular death at 12 months compared with placebo.Clinical Trial Registration: URL: http://www.clinicaltrials.gov Unique identifier: NCT02831608.
|
|
| 10. |
- Grip, Lena, 1978-, et al.
(författare)
-
Crisis communication with tourists of the grid. : Incorporating the Swedish tourism sector in crisis management and communication – methods and strategies for preparedness and collaboration in rural areas
- 2021
-
Konferensbidrag (refereegranskat)abstract
- Our changing climate foretells a future with continued large forest fires and extreme weather events, such as devastating storms, heavy rainfall, flooding, heat and drought. This project focuses on preparedness for this kind of events taking place while large, spread-out, and often uncertain, numbers of visitors are roaming the Swedish countryside – not seldom voluntarily or involuntarily of the grid. The conditions for crisis communication is changing with social media, apps and digitalization of information. Obstacles and possibilities for digitalization in the tourism sector in relation to the specific conditions of nature-based tourism needs more attention.Tourists are a vulnerable group in crisis situations, since they are not acquainted with neither the place nor how to find information about the crisis and how to keep themselves safe. In parallel, the Swedish tourism sector is constantly growing, with new trends as ”vacation at home” and increasing numbers of international tourists visiting Swedish nature, and nature-based tourism is believed to see a significant increase in post-pandemic travel, as more visitors seek uncrowded destinations. A crisis can be devastating in nature tourist areas. Despite this, the tourism sector is often viewed as peripheral and is in some cases not even included in crisis preparedness planning. The aim of this study is to generate new knowledge and methods for incorporating the Swedish countryside tourism sector in crisis management and communication. Crisis management and risk preparedness and awareness, and collaborations and relations between the tourism sector and other crisis management actors (municipalities and public authorities) are in focus, as well as the nature tourists themselves.
|
|
