| 1. |
- Alfredsson, Joakim, 1962-, et al.
(författare)
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Randomized comparison of early supplemental oxygen versus ambient air in patients with confirmed myocardial infarction : Sex-related outcomes from DETO2X-AMI
- 2021
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Ingår i: American Heart Journal. - : Mosby Inc.. - 0002-8703 .- 1097-6744. ; 237, s. 13-24
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study is to investigate the impact of oxygen therapy on cardiovascular outcomes in relation to sex in patients with confirmed myocardial infarction (MI).Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction trial randomized 6,629 patients to oxygen at 6 L/min for 6-12 hours or ambient air. In the present subgroup analysis including 5,010 patients (1,388 women and 3,622 men) with confirmed MI, we report the effect of supplemental oxygen on the composite of all-cause death, rehospitalization with MI, or heart failure at long-term follow-up, stratified according to sex.Results: Event rate for the composite endpoint was 18.1% in women allocated to oxygen, compared to 21.4% in women allocated to ambient air (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.65-1.05). In men, the incidence was 13.6% in patients allocated to oxygen compared to 13.3% in patients allocated to ambient air (HR 1.03, 95% CI 0.86-1.23). No significant interaction in relation to sex was found (P=.16). Irrespective of allocated treatment, the composite endpoint occurred more often in women compared to men (19.7 vs 13.4%, HR 1.51; 95% CI, 1.30-1.75). After adjustment for age alone, there was no difference between the sexes (HR 1.06, 95% CI 0.91-1.24), which remained consistent after multivariate adjustment.Conclusion: Oxygen therapy in normoxemic MI patients did not significantly affect all-cause mortality or rehospitalization for MI or heart failure in women or men. The observed worse outcome in women was explained by differences in baseline characteristics, especially age
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| 2. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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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.
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| 3. |
- Bergström, Göran, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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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.
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| 4. |
- Pertsinidou, Eleftheria, et al.
(författare)
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In early rheumatoid arthritis, anticitrullinated peptide antibodies associate with low number of affected joints and rheumatoid factor associates with systemic inflammation
- 2024
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 83:3, s. 277-287
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate how individual rheumatoid arthritis (RA) autoantibodies associate with individual signs and symptoms at the time of RA diagnosis.Methods: IgA, IgG, IgM rheumatoid factor (RF), antibodies against cyclic citrullinated peptide version 2 (anti-CCP2) and 16 individual antibodies against citrullinated protein (ACPA) reactivities were analysed centrally in baseline sera from 1600 patients with RA classified according to the 1987 American College of Rheumatology (ACR) criteria. These results were related to C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), number of swollen and tender joints (SJC and TJC), 28-joint disease activity scores (DAS28 and DAS28CRP), global disease activity evaluated by the patients and Health Assessment Questionnaire, all obtained at baseline.Results: Individually, all autoantibodies except immunoglobulin G (IgG) RF associated with low SJC and TJC and with high ESR. In IgM RF-negative patients, ACPA associated strictly with low number of swollen and tender joints. This association persisted in multiple regression and stratified analyses where IgM and IgA RF instead associated with inflammation expressed as ESR. Among subjects without any ACPA peptide reactivity, there was no association between RF isotypes and ESR. The effect of RF on ESR increased with the number of ACPA reactivities, especially for IgM RF. In patients fulfilling the 1987 ACR criteria without taking RF into account, associations between IgM RF and high ESR, as well as between ACPA and low joint counts, remained.Conclusion: Whereas ACPA associate with low counts of affected joints in early RA, RF associates with elevated measures of systemic inflammation in an ACPA-dependent manner. This latter finding corroborates in vitro models of ACPA and RF in immune complex-induced inflammation. These phenotypic associations are independent of classification criteria.
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| 5. |
- Westerlind, Helga, et al.
(författare)
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Anti-Citrullinated Protein Antibody Specificities, Rheumatoid Factor Isotypes, and Incident Cardiovascular Events in Patients With Rheumatoid Arthritis
- 2020
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Ingår i: Arthritis & Rheumatology. - : John Wiley & Sons. - 2326-5191 .- 2326-5205. ; 72:10, s. 1658-1667
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the relationship between anti–citrullinated protein antibodies (ACPAs), specific ACPA subspecificities, rheumatoid factor (RF) isotypes, and incident cardiovascular (CV) events in patients with rheumatoid arthritis (RA).Methods Serum samples from Swedish patients with new-onset RA (diagnosed within 1 year of symptom onset between 1996 and 2009) were centrally typed for anti–cyclic citrullinated peptide 2 (anti-CCP2) antibodies, 20 ACPA subspecificities, and RF isotypes. Patients were followed up longitudinally in nationwide registers to monitor the occurrence of acute coronary syndrome (ACS), stroke, CV-related death, and major adverse CV events (MACE). The association between each serologic marker and CV outcome, and the impact of adjustment for the Disease Activity Score in 28 joints (DAS28), smoking status, and income at baseline, were assessed using Cox proportional hazards models. In addition, associations of serologic markers with all-cause mortality were explored.Results In total, 2,814 patients with RA were included in the study. The median follow-up was 13 years, during which the CV end points of ACS, stroke, or CV-related death were reported to occur in 375 patients. Occurrence and/or levels of anti-CCP2 were associated with risk of incident ACS (hazard ratio [HR] 1.46, 95% confidence interval [95% CI] 1.03–2.06), stroke (HR 1.47, 95% CI 1.03–2.10), CV-related death (P = 0.024 for association with anti-CCP2 levels), and MACE (HR 1.34, 95% CI 1.06–1.70). Similarly, an association with the number of ACPA subspecificities was observed; however, this could not be attributed to any individual or group of ACPA subspecificities. Presence of IgM-RF was associated with all CV end points except ACS, and IgA-RF was exclusively associated with CV-related death. Adjustment for smoking status, income, and DAS28 scores decreased most of the HRs, whereas IgA-RF remained associated with CV-related death (HR 1.61, 95% CI 1.05–2.48). All of the assessed serologic makers were associated with all-cause mortality.Conclusion RF isotypes and ACPAs are associated with future CV events in patients with RA. ACPA levels and number of subspecificities seem more important than the occurrence of particular subspecificities, and these associations were not explained by a history of ever smoking.
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| 6. |
- Abbas, Muhammad Tahir, et al.
(författare)
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Energy-Saving Solutions for Cellular Internet of Things - A Survey
- 2022
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Ingår i: IEEE Access. - IEEE : IEEE. - 2169-3536. ; 10, s. 62096-62096
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Tidskriftsartikel (refereegranskat)abstract
- The Cellular Internet of Things (CIoT), a new paradigm, paves the way for a large-scale deployment of IoT devices. CIoT promises enhanced coverage and massive deployment of low-cost IoT devices with an expected battery life of up to 10 years. However, such a long battery life can only be achieved provided the CIoT device is configured with energy efficiency in mind. This paper conducts a comprehensive survey on energy-saving solutions in 3GPP-based CIoT networks. In comparison to current studies, the contribution of this paper is the classification and an extensive analysis of existing energy-saving solutions for CIoT, e.g., the configuration of particular parameter values and software modifications of transport- or radio-layer protocols, while also stressing key parameters impacting the energy consumption such as the frequency of data reporting, discontinuous reception cycles (DRX), and Radio Resource Control (RRC) timers. In addition, we discuss shortcomings, limitations, and possible opportunities which can be investigated in the future to reduce the energy consumption of CIoT devices.
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| 7. |
- Abbas, Muhammad Tahir, et al.
(författare)
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Guidelines for an Energy Efficient Tuning of the NB-IoT Stack
- 2020
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Ingår i: 45th IEEE Conference on Local Computer Networks (LCN). - : IEEE Communications Society. ; , s. 60-69
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Konferensbidrag (refereegranskat)abstract
- In this paper, we study the energy consumptionof Narrowband IoT devices. The paper suggests that key tosaving energy for NB-IoT devices is the usage of full Discontinuous Reception (DRX), including the use of connected-mode DRX (cDRX): In some cases, cDRX reduced the energy consumption over a 10-year period with as much as 50%. However, the paper also suggests that tunable parameters, such as the inactivity timer, do have a significant impact. On the basis of our findings, guidelines are provided on how to tune the NB-IoT device so that it meets the target of the 3GPP, i.e., a 5-Wh battery should last for at least 10 years. It is further evident from our results that the energy consumption is largely dependent on the intensity and burstiness of the traffic, and thus could be significantly reduced if data is sent in bursts with less intensity,irrespective of cDRX support.
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| 8. |
- Abbas, Muhammad Tahir
(författare)
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Improving the Energy Efficiency of Cellular IoT Device
- 2023
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cellular Internet of Things (CIoT) has emerged as a promising technology to support applications that generate infrequent data. One requirement on these applications, often battery-powered devices, is low energy consumption to enable extended battery life. Narrowband IoT (NB-IoT) is a promising technology for IoT due to its low power consumption, which is essential for devices that need to run on battery power for extended periods. However, the current battery life of NB-IoT devices is only a few years, which is insufficient for many applications. This thesis investigates the impact of energy-saving mechanisms standardized by 3GPP on battery life of NB-IoT devices. The main research objective is to classify and analyze existing energy-saving solutions for CIoT and examine their limitations, to study the impact of standardized energy-saving mechanisms on the battery life of NB-IoT devices, both in isolation and combined, and to provide guidelines on how to configure NB-IoT devices to reduce energy consumption efficiently. The research aims to provide a deeper understanding of the effect of energy-saving mechanisms and best practices to balance energy efficiency and performance of NB-IoT devices. Applying the proposed solutions makes it possible to achieve a battery life of 10~years or more for CIoT devices.
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| 9. |
- Abbas, Muhammad Tahir, et al.
(författare)
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On the Energy-efficient Use of Discontinuous Reception and Release Assistance in NB-IoT
- 2022
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Konferensbidrag (refereegranskat)abstract
- Cellular Internet of Things (CIoT) is a Low-Power Wide-Area Network (LPWAN) technology. It aims for cheap, lowcomplexity IoT devices that enable large-scale deployments and wide-area coverage. Moreover, to make large-scale deployments of CIoT devices in remote and hard-to-access locations possible, a long device battery life is one of the main objectives of these devices. To this end, 3GPP has defined several energysaving mechanisms for CIoT technologies, not least for the Narrow-Band Internet of Things (NB-IoT) technology, one of the major CIoT technologies. Examples of mechanisms defined include CONNECTED-mode DRX (cDRX), Release Assistance Indicator (RAI), and Power Saving Mode (PSM). This paper considers the impact of the essential energy-saving mechanisms on minimizing the energy consumption of NB-IoT devices, especially the cDRX and RAI mechanisms. The paper uses a purpose-built NB-IoT simulator that has been tested in terms of its built-in energy-saving mechanisms and validated with realworld NB-IoT measurements. The simulated results show that it is possible to save 70%-90% in energy consumption by enabling the cDRX and RAI. In fact, the results suggest that a battery life of 10 years is only achievable provided the cDRX, RAI, and PSM energy-saving mechanisms are correctly configured and used
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| 10. |
- Abbas, Muhammad Tahir, et al.
(författare)
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Towards zero-energy : Navigating the future with 6G in Cellular Internet of Things
- 2024
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Ingår i: Journal of Network and Computer Applications. - : Elsevier. - 1084-8045 .- 1095-8592. ; 230
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Tidskriftsartikel (refereegranskat)abstract
- The Cellular Internet of Things (CIoT) has seen significant growth in recent years. With the deployment of 5G, it has become essential to reduce the power consumption of these devices for long-term sustainability. The upcoming 6G cellular network introduces the concept of zero-energy CIoT devices, which do not require batteries or manual charging. This paper focuses on these devices, providing insight into their feasibility and practical implementation. The paper examines how CIoT devices use simultaneous wireless information and power transfer, beamforming, and backscatter communication techniques. It also analyzes the potential use of energy harvesting and power management in zero-energy CIoT devices. Furthermore, the paper explores how low-power transceivers can lower energy usage while maintaining dependable communication functions.
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