| 1. |
- Blennow Nordström, Erik, et al.
(författare)
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Neuropsychological outcome after cardiac arrest : results from a sub-study of the targeted hypothermia versus targeted normothermia after out-of-hospital cardiac arrest (TTM2) trial
- 2023
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Ingår i: Critical Care. - : BioMed Central (BMC). - 1364-8535 .- 1466-609X. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cognitive impairment is common following out-of-hospital cardiac arrest (OHCA), but the nature of the impairment is poorly understood. Our objective was to describe cognitive impairment in OHCA survivors, with the hypothesis that OHCA survivors would perform significantly worse on neuropsychological tests of cognition than controls with acute myocardial infarction (MI). Another aim was to investigate the relationship between cognitive performance and the associated factors of emotional problems, fatigue, insomnia, and cardiovascular risk factors following OHCA.METHODS: This was a prospective case-control sub-study of The Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial. Eight of 61 TTM2-sites in Sweden, Denmark, and the United Kingdom included adults with OHCA of presumed cardiac or unknown cause. A matched non-arrest control group with acute MI was recruited. At approximately 7 months post-event, we administered an extensive neuropsychological test battery and questionnaires on anxiety, depression, fatigue, and insomnia, and collected information on the cardiovascular risk factors hypertension and diabetes.RESULTS: Of 184 eligible OHCA survivors, 108 were included, with 92 MI controls enrolled. Amongst OHCA survivors, 29% performed z-score ≤ - 1 (at least borderline-mild impairment) in ≥ 2 cognitive domains, 14% performed z-score ≤ - 2 (major impairment) in ≥ 1 cognitive domain while 54% performed without impairment in any domain. Impairment was most pronounced in episodic memory, executive functions, and processing speed. OHCA survivors performed significantly worse than MI controls in episodic memory (mean difference, MD = - 0.37, 95% confidence intervals [- 0.61, - 0.12]), verbal (MD = - 0.34 [- 0.62, - 0.07]), and visual/constructive functions (MD = - 0.26 [- 0.47, - 0.04]) on linear regressions adjusted for educational attainment and sex. When additionally adjusting for anxiety, depression, fatigue, insomnia, hypertension, and diabetes, executive functions (MD = - 0.44 [- 0.82, - 0.06]) were also worse following OHCA. Diabetes, symptoms of anxiety, depression, and fatigue were significantly associated with worse cognitive performance.CONCLUSIONS: In our study population, cognitive impairment was generally mild following OHCA. OHCA survivors performed worse than MI controls in 3 of 6 domains. These results support current guidelines that a post-OHCA follow-up service should screen for cognitive impairment, emotional problems, and fatigue.TRIAL REGISTRATION: ClinicalTrials.gov, NCT03543371. Registered 1 June 2018.
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| 2. |
- Dragsted, L., et al.
(författare)
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Metabolomic response to Nordic foods
- 2015
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Ingår i: Annals of Nutrition and Metabolism. - 0250-6807 .- 1421-9697. ; 67, s. 55-55
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 3. |
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| 4. |
- Holgersson, Johan, et al.
(författare)
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Hypothermic versus Normothermic Temperature Control after Cardiac Arrest
- 2022
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Ingår i: NEJM Evidence. - 2766-5526. ; 1:11, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThe evidence for temperature control for comatose survivors of cardiac arrest is inconclusive. Controversy exists as to whether the effects of hypothermia differ per the circumstances of the cardiac arrest or patient characteristics.METHODSAn individual patient data meta-analysis of the Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest (TTM) and Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trials was conducted. The intervention was hypothermia at 33°C and the comparator was normothermia. The primary outcome was all-cause mortality at 6 months. Secondary outcomes included poor functional outcome (modified Rankin scale score of 4 to 6) at 6 months. Predefined subgroups based on the design variables in the original trials were tested for interaction with the intervention as follows: age (older or younger than the median), sex (female or male), initial cardiac rhythm (shockable or nonshockable), time to return of spontaneous circulation (above or below the median), and circulatory shock on admission (presence or absence).RESULTSThe primary analyses included 2800 patients, with 1403 assigned to hypothermia and 1397 to normothermia. Death occurred for 691 of 1398 participants (49.4%) in the hypothermia group and 666 of 1391 participants (47.9%) in the normothermia group (relative risk with hypothermia, 1.03; 95% confidence interval [CI], 0.96 to 1.11; P=0.41). A poor functional outcome occurred for 733 of 1350 participants (54.3%) in the hypothermia group and 718 of 1330 participants (54.0%) in the normothermia group (relative risk with hypothermia, 1.01; 95% CI, 0.94 to 1.08; P=0.88). Outcomes were consistent in the predefined subgroups.CONCLUSIONSHypothermia at 33°C did not decrease 6-month mortality compared with normothermia after out-of-hospital cardiac arrest. (Funded by Vetenskapsrådet; ClinicalTrials.gov numbers NCT02908308 and NCT01020916.)
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| 5. |
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| 6. |
- Murphy, Kathleen, 1972, et al.
(författare)
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Fluorescence spectroscopy and multi-way techniques. PARAFAC
- 2013
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Ingår i: Analytical Methods. - : Royal Society of Chemistry (RSC). - 1759-9679 .- 1759-9660. ; 5:23, s. 6557-6566
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Tidskriftsartikel (refereegranskat)abstract
- PARAllel FACtor analysis (PARAFAC) is increasingly used to decompose fluorescence excitation emission matrices (EEMs) into their underlying chemical components. In the ideal case where fluorescence conforms to Beers Law, this process can lead to the mathematical identification and quantification of independently varying fluorophores. However, many practical and analytical hurdles stand between EEM datasets and their chemical interpretation. This article provides a tutorial in the practical application of PARAFAC to fluorescence datasets, demonstrated using a dissolved organic matter (DOM) fluorescence dataset. A new toolbox for MATLAB is presented to support improved visualisation and sensitivity analyses of PARAFAC models in fluorescence spectroscopy. © 2013 The Royal Society of Chemistry.
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| 7. |
- Murphy, Kathleen, 1972, et al.
(författare)
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OpenFluor- an online spectral library of auto-fluorescence by organic compounds in the environment
- 2014
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Ingår i: Analytical Methods. - : Royal Society of Chemistry (RSC). - 1759-9679 .- 1759-9660. ; 6:3, s. 658-661
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Tidskriftsartikel (refereegranskat)abstract
- An online repository of published organic fluorescence spectra has been developed, which can be searched for quantitative matches with any set of unknown spectra. It fills a critical gap by increasing access to measured and modelled (PARAFAC) spectra, and linking across studies and systems to reveal "global" fluorescence trends.
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| 8. |
- Paradina-Fernández, Lesly, et al.
(författare)
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Direct Measurement of Organic Micropollutants in Water and Wastewater Using Fluorescence Spectroscopy
- 2023
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Ingår i: ACS ES and T Water. - 2690-0637. ; 3:12, s. 3905-3915
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Tidskriftsartikel (refereegranskat)abstract
- Quantifying organic micropollutants (OMPs) in aquatic environments and assessing their removal by water treatment requires expensive and time-consuming analyses typically using liquid chromatographic separation and tandem mass spectrometry (LC-MS/MS). In this study, we evaluated the potential for detecting fluorescent OMPs via spectroscopy, which is cheap, rapid, and widely accessible. The method involved using a priori PARAFAC models to eliminate interfering background fluorescence emitted by naturally occurring dissolved organic matter. Of 20 screened pharmaceutical OMPs, three (ciprofloxacin, naproxen, and zolpidem) with calculated fluorescence quantum yields 0.14, 0.21, and 0.71, respectively, could be quantified in the low μg L-1 range when added alone or in combination to water samples without any sample pretreatment other than filtration and pH adjustment. Limits of detection for all three OMPs were 1.0-3.3 μg L-1 in surface waters, while in wastewater, they were 0.6-9.0 μg L-1 for ciprofloxacin and naproxen and 1.0-2.6 μg L-1 for zolpidem. Given the high cost of pharmaceutical analyses and widespread availability of fluorometers, the new approach will improve access to rapid and cost-effective results by supporting data-intensive lab-scale studies, wherein the types of OMPs studied and their concentration ranges are under the control of the analyst.
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