| 1. |
- Andrén, Kerstin, 1980, et al.
(författare)
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Adherence to anti-seizure medications in the Swedish Prospective Regional Epilepsy Database and Biobank for Individualized Clinical Treatment (PREDICT)
- 2023
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Ingår i: Epilepsy and Behavior Reports. - 2589-9864. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the extent of, and risk factors for, non-adherence to anti-seizure medications (ASMs) in adult people with epilepsy (PWE) in Sweden. A cross-sectional multi-centre study was performed of PWEs in western Sweden, with data from medical records, and a questionnaire filled in by the participants including self-reports on how often ASM doses had been forgotten during the past year. Participants were categorized into adherent if they forgot at 0–1 occasion, and non-adherent if they forgot at 2–10 or >10 occasions. Demographic and clinical factors were compared by Chi2- or Fisher's test and a logistic regression model was used to find risk factors for non-adherence. In the cohort of 416 PWE aged median 43, IQR 29–62 years, 398 patients were prescribed ASM treatment at inclusion, and 39 % (n = 154) were in the non-adherent group. Significant factors in the multivariable analysis were: younger age, seizure freedom the past year, valproate treatment and experiencing side effects. The rate of self-reported non-adherence was high, illustrating a need for continuous focus on fundamental aspects of epilepsy care. The identified risk factors could enable quality improvement projects and patient education to be directed to those at risk of non-adherence.
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| 2. |
- Banote, Rakesh Kumar, et al.
(författare)
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Quantitative proteomic analysis to identify differentially expressed proteins in patients with epilepsy
- 2021
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Ingår i: Epilepsy Research. - : Elsevier BV. - 0920-1211 .- 1872-6844. ; 174
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Tidskriftsartikel (refereegranskat)abstract
- There is a great need for biomarkers in epilepsy, particularly markers of epileptogenesis. A first seizure will lead to epilepsy in 20-45 % of cases, but biomarkers that can identify these individuals are missing. The purpose of this study was to identify potential biomarkers of epilepsy/epileptogenesis in a cohort of adults with new-onset seizures, using quantitative proteomic analysis. Plasma was collected from 55 adults with new-onset seizures and sufficient follow-up to identify epilepsy. After a follow up period of two years, 63.6 % of the cohort had a diagnosis of epilepsy, whereas 36.4 % of patients only had a single seizure. Plasma proteins were extracted and labelled with tandem mass tags, then analyzed using mass spectrometry approach. Proteins that were up- or downregulated by >= 20 % and with a pvalue of <0.05 were considered as differentially expressed and were also annotated to their processes and pathways. Several proteins were differentially expressed in the epilepsy group compared to controls. A total of 1075 proteins were detected, out of which 41 proteins were found to be significantly dysregulated in epilepsy patients. Many of these have been identified in experimental studies of epilepogenesis. We report plasma proteome profiling in new-onset epilepsy in a pilot study with 55 individuals. The identified proteins could be involved in pathways associated with epileptogenesis. The results should be seen as hypothesisgenerating and targeted, confirmatory studies are needed.
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| 3. |
- Bardizbanyan, Alen, 1986, et al.
(författare)
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Designing a Practical Data Filter Cache to Improve Both Energy Efficiency and Performance
- 2013
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Ingår i: Transactions on Architecture and Code Optimization. - 1544-3973 .- 1544-3566. ; 10:4, s. 25 pages-
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Tidskriftsartikel (refereegranskat)abstract
- Conventional Data Filter Cache (DFC) designs improve processor energy efficiency, but degrade performance. Furthermore, the single-cycle line transfer suggested in prior studies adversely affects Level-1 Data Cache (L1 DC) area and energy efficiency. We propose a practical DFC that is accessed early in the pipeline and transfers a line over multiple cycles. Our DFC design improves performance and eliminates a substantial fraction of L1 DC accesses for loads, L1 DC tag checks on stores, and data translation lookaside buffer accesses for both loads and stores. Our evaluation shows that the proposed DFC can reduce the data access energy by 42.5% and improve execution time by 4.2%.
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| 4. |
- Bardizbanyan, Alen, 1986, et al.
(författare)
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Improving Data Access Efficiency by Using a Tagless Access Buffer (TAB)
- 2013
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Ingår i: Proceedings of the 2013 IEEE/ACM International Symposium on Code Generation and Optimization, CGO 2013. - 9781467355254 ; , s. 269-279
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Konferensbidrag (refereegranskat)abstract
- The need for energy efficiency continues to grow for many classes of processors, including those for which performance remains vital. Data cache is crucial for good performance, but it also represents a significant portion of the processor's energy expenditure. We describe the implementation and use of a tagless access buffer (TAB) that greatly improves data access energy efficiency while slightly improving performance. The compiler recognizes memory reference patterns within loops and allocates these references to a TAB. This combined hardware/software approach reduces energy usage by (1) replacing many level-one data cache (L1D) accesses with accesses to the smaller, more power-efficient TAB; (2) removing the need to perform tag checks or data translation lookaside buffer (DTLB) lookups for TAB accesses; and (3) reducing DTLB lookups when transferring data between the L1D and the TAB. Accesses to the TAB occur earlier in the pipeline, and data lines are prefetched from lower memory levels, which result in asmall performance improvement. In addition, we can avoid many unnecessary block transfers between other memory hierarchy levels by characterizing how data in the TAB are used. With a combined size equal to that of a conventional 32-entry register file, a four-entry TAB eliminates 40% of L1D accesses and 42% of DTLB accesses, on average. This configuration reduces data-access related energy by 35% while simultaneously decreasing execution time by 3%.
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| 5. |
- Bardizbanyan, Alen, 1986, et al.
(författare)
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Improving data access efficiency by using context-aware loads and stores
- 2015
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Ingår i: Proc. 16th ACM SIGPLAN/SIGBED Conference on Languages, Compilers, and Tools for Embedded Systems. - New York : ACM Press. - 0730-8566. - 9781450332576 ; , s. 27-36
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Konferensbidrag (refereegranskat)abstract
- Memory operations have a significant impact on both performance and energy usage even when an access hits in the level-one data cache (L1 DC). Load instructions in particular affect performance as they frequently result in stalls since the register to be loaded is often referenced before the data is available in the pipeline. L1 DC accesses also impact energy usage as they typically require significantly more energy than a register file access. Despite their impact on performance and energy usage, L1 DC accesses on most processors are performed in a general fashion without regard to the context in which the load or store operation is performed. We describe a set of techniques where the compiler enhances load and store instructions so that they can be executed with fewer stalls and/or enable the L1 DC to be accessed in a more energy-efficient manner. We show that using these techniques can simultaneously achieve a 6% gain in performance and a 43% reduction in L1 DC energy usage.
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| 6. |
- Bardizbanyan, Alen, 1986, et al.
(författare)
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Speculative Tag Access for Reduced Energy Dissipation in Set-Associative L1 Data Caches
- 2013
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Ingår i: Proceedings of IEEE International Conference on Computer Design (ICCD), Asheville, NC, USA, October 6-9 2013. ; , s. 302-308
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Konferensbidrag (refereegranskat)abstract
- Due to performance reasons, all ways in set-associative level-one (L1) data caches are accessed in parallel for load operations even though the requested data can only reside in one of the ways. Thus, a significant amount of energy is wasted when loads are performed. We propose a speculation technique that performs the tag comparison in parallel with the address calculation, leading to the access of only one way during the following cycle on successful speculations. The technique incurs no execution time penalty, has an insignificant area overhead, and does not require any customized SRAM implementation. Assuming a 16kB 4-way set-associative L1 data cache implemented in a 65-nm process technology, our evaluation based on 20 different MiBench benchmarks shows that the proposed technique on average leads to a 24% data cache energy reduction.
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| 7. |
- Bardizbanyan, Alen, 1986, et al.
(författare)
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Towards a Performance- and Energy-Efficient Data Filter Cache
- 2013
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Ingår i: Workshop on Optimizations for DSP and Embedded Systems (ODES), Proceedings of International Symposium on Code Generation and Optimization (CGO), Shenzhen, China, Feb. 23-27. - New York, NY, USA : ACM. - 9781450319058 ; , s. 21-28
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Konferensbidrag (refereegranskat)abstract
- As CPU data requests to the level-one (L1) data cache (DC) can represent as much as 25% of an embedded processor's total power dissipation, techniques that decrease L1 DC accesses can significantly enhance processor energy efficiency. Filter caches are known to efficiently decrease the number of accesses to instruction caches. However, due to the irregular access pattern of data accesses, a conventional data filter cache (DFC) has a high miss rate, which degrades processor performance. We propose to integrate a DFC with a fast address calculation technique to significantly reduce the impact of misses and to improve performance by enabling one-cycle loads. Furthermore, we show that DFC stalls can be eliminated even after unsuccessful fast address calculations, by simultaneously accessing the DFC and L1 DC on the following cycle. We quantitatively evaluate different DFC configurations, with and without the fast address calculation technique, using different write allocation policies, and qualitatively describe their impact on energy efficiency. The proposed design provides an efficient DFC that yields both energy and performance improvements.
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| 8. |
- Da Silva Faria Oliveira, Fábio Luis, 1985, et al.
(författare)
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Genomic and transcriptomic analysis of Candida intermedia reveals important genes for xylose utilization
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The urgency to reduce carbon emissions and to lower our dependence on oil makes it necessary to strive towards a more sustainable bio-based economy, where energy, chemicals, materials and food are produced from renewable resources. Lignocellulosic biomass constitutes a great source of raw material for such a future bio-based economy since it is widely available, relatively inexpensive and do not compete with food and feed production. The pentose D-xylose, the second most prevalent sugar in lignocellulose after glucose, is an underutilized resource, in large due to the inefficient fermentation of this sugar by the most industrially relevant microorganisms (e.g. Saccharomyces cerevisiae). Thus, development of microorganisms that can ferment all lignocellulosic sugars is of foremost importance for economically viable production processes. Native xylose-utilizing yeasts represent a major source of knowledge and genes for xylose uptake and assimilation that can be transferred to S. cerevisiae. The yeast Candida intermedia is an interesting candidate to characterize further, as it displays a high xylose transport capacity and multiple xylose reductases, of which one appears to prefer NADH over NAPDH. Furthermore, the C. intermedia strain CBS 141442, isolated in the liquid fraction of wheat straw hydrolysate in our laboratory as a contaminant of a xylose fermenting population of S. cerevisiae, is capable of glucose and xylose co-fermentation under certain conditions. The aim of this study was to elucidate the genetic features that are the basis of the xylose utilization capacity of C. intermedia CBS141442. PacBio sequencing and de novo assembly of the genome revealed a haploid yeast with a genome size of 13.2 Mb and a total of 5936 protein-coding genes spread over seven chromosomes. In order to gain insight on the genes involved in the utilization of xylose, we analysed the changes in the transcriptome of C. intermedia CBS141442 during growth in xylose and glucose (as reference condition). Cells were collected in mid-exponential phase at the maximum growth rate when no metabolites were accumulating. The total RNA was extracted and cDNA libraries were prepared after polyA selection. Each sample was sequenced in an Illumina HiSeq2500 system with an average cover of 5-20 million reads. The analysis of the differential expression data lead to the identification of two new genes potentially encoding xylose transporters and no less than three xylose reductases genes with different expression patterns. The xylose reductase genes were heterologously expressed in S. cerevisiae to determine their co-factor preferences and substrate specificities. Whereas two of them are strictly NADPH-dependent, the third can use both co-factors and shows preference for NADH. The heterologous expression of this gene can improve the capacity of S. cerevisiae to ferment xylose, and thus contribute to a more efficient use of lignocellulosic biomass.
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| 9. |
- Eriksson, Hanna, et al.
(författare)
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Brain injury markers in new-onset seizures in adults: A pilot study
- 2021
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Ingår i: Seizure-European Journal of Epilepsy. - : Elsevier BV. - 1059-1311. ; 92, s. 62-67
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Tidskriftsartikel (refereegranskat)abstract
- Background: Biochemical markers of brain pathology could potentially contribute to diagnosis and prediction in epilepsy. We describe levels of five brain injury markers in adults with new-onset seizures, and assess group differences in patients with a single seizure, epilepsy, and poststroke epilepsy. Methods: In this prospective observational study, adults with new-onset seizures were recruited at Sahlgrenska University Hospital, Sweden, and concentrations of glial fibrillary acidic protein (GFAP), neurofilament light (NfL), microtubule-associated protein tau (tau), S100 calcium-binding protein (S100B), and neuron-specific enolase (NSE) were measured. Participants were categorized as epilepsy, poststroke epilepsy (PSE), or single seizure (no additional seizures). Patients were followed until a diagnosis of epilepsy or PSE, or for at least two years in single seizure cases. Results: The cohort included 23 (37%) individuals with a single seizure, 24 (39%) with epilepsy, and 15 (24%) with PSE. The concentrations of S100B were higher in patients with epilepsy and PSE than in single seizures (p = 0.0023 and p = 0.0162, respectively). The concentrations of NfL were higher in patients with PSE than in single seizures (p=0.0027). After age-normalization, levels of S100B were higher in patients with epilepsy and levels of NfL were higher in patients with PSE (p = 0.0021 and p = 0.0180). Conclusion: Levels of S100B and NfL were higher in patients with epilepsy or PSE than patients with single seizures. Further studies are needed to investigate the biomarker potential of brain injury markers as predictors of epilepsy course or indicators of epileptogenesis.
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| 10. |
- Håkansson, Samuel, 1996, et al.
(författare)
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Potential for improved retention rate by personalized antiseizure medication selection: A register-based analysis
- 2021
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Ingår i: Epilepsia. - : Wiley. - 0013-9580 .- 1528-1167. ; 62:9, s. 2123-2132
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Tidskriftsartikel (refereegranskat)abstract
- Objective The first antiseizure medication (ASM) is ineffective or intolerable in 50% of epilepsy cases. Selection between more than 25 available ASMs is guided by epilepsy factors, but also age and comorbidities. Randomized evidence for particular patient subgroups is seldom available. We asked whether register data could be used for retention rate calculations based on demographics, comorbidities, and ASM history, and quantified the potential improvement in retention rates of the first ASM in several large epilepsy cohorts. We also describe retention rates in patients with epilepsy after traumatic brain injury and dementia, patient groups with little available evidence. Methods We used medical, demographic, and drug prescription data from epilepsy cohorts from comprehensive Swedish registers, containing 6380 observations. By analyzing 381 840 prescriptions, we studied retention rates of first- and second-line ASMs for patients with epilepsy in multiple sclerosis (MS), brain infection, dementia, traumatic brain injury, or stroke. The rank of retention rates of ASMs was validated by comparison to published randomized control trials. We identified the optimal stratification for each brain disease, and quantified the potential improvement if all patients had received the optimal ASM. Results Using optimal stratification for each brain disease, the potential improvement in retention rate (percentage points) was MS, 20%; brain infection, 21%; dementia, 14%; trauma, 21%; and stroke, 14%. In epilepsy after trauma, levetiracetam had the highest retention rate at 80% (95% confidence interval [CI] = 65-89), exceeding that of the most commonly prescribed ASM, carbamazepine (p = .04). In epilepsy after dementia, lamotrigine (77%, 95% CI = 68-84) and levetiracetam (74%, 95% CI = 68-79) had higher retention rates than carbamazepine (p = .006 and p = .01, respectively). Significance We conclude that personalized ASM selection could improve retention rates and that national registers have potential as big data sources for personalized medicine in epilepsy.
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