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- Uszko-Lencer, Nhmk, et al.
(författare)
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Clustering based on comorbidities in patients with chronic heart failure: an illustration of clinical diversity
- 2022
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Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 9:1, s. 614-626
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Tidskriftsartikel (refereegranskat)abstract
- Aims It is increasingly recognized that the presence of comorbidities substantially contributes to the disease burden in patients with heart failure (HF). Several reports have suggested that clustering of comorbidities can lead to improved characterization of the disease phenotypes, which may influence management of the individual patient. Therefore, we aimed to cluster patients with HF based on medical comorbidities and their treatment and, subsequently, compare the clinical characteristics between these clusters. Methods and results A total of 603 patients with HF entering an outpatient HF rehabilitation programme were included [median age 65 years (interquartile range 56-71), 57% ischaemic origin of cardiomyopathy, and left ventricular ejection fraction 35% (26-45)]. Exercise performance, daily life activities, disease-specific health status, coping styles, and personality traits were assessed. In addition, the presence of 12 clinically relevant comorbidities was recorded, based on targeted diagnostics combined with applicable pharmacotherapies. Self-organizing maps (SOMs; ) were used to visualize clusters, generated by using a hybrid algorithm that applies the classical hierarchical cluster method of Ward on top of the SOM topology. Five clusters were identified: (1) a least comorbidities cluster; (2) a cachectic/implosive cluster; (3) a metabolic diabetes cluster; (4) a metabolic renal cluster; and (5) a psychologic cluster. Exercise performance, daily life activities, disease-specific health status, coping styles, personality traits, and number of comorbidities were significantly different between these clusters. Conclusions Distinct combinations of comorbidities could be identified in patients with HF. Therapy may be tailored based on these clusters as next step towards precision medicine. The effect of such an approach needs to be prospectively tested.
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- Sudireddy, B. R., et al.
(författare)
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Development of Robust Metal-Supported SOFCs and Stack Components in EU METSAPP Consortium
- 2017
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Ingår i: Fuel Cells. - : Wiley. - 1615-6846 .- 1615-6854. ; 17:4, s. 508-516
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Tidskriftsartikel (refereegranskat)abstract
- The potential of MS-SOFCs was demonstrated through the previous EU METSOFC project, which concluded that the development of oxidation resistant novel metal-supported solid oxide fule cell (MS-SOFC) design and stack is the requirement to advance this technology to the next level. The following EU METSAPP project has been executed with an overall aim of developing advanced metal-supported cells and stacks based on a robust, reliable and up-scalable technology. During the project, oxidation resistant nanostructured anodes based on modified SrTiO3 were developed and integrated into MS-SOFCs to enhance their robustness. In addition, the manufacturing of metal-supported cells with different geometries, scalability of the manufacturing process was demonstrated and more than 200 cells with an area of approximate to 150 cm(2) were produced. The electrochemical performance of different cell generations was evaluated and best performance and stability combination was observed with doped SrTiO3 based anode designs. Furthermore, numerical models to understand the corrosion behavior of the MS-SOFCs were developed and validated. Finally, the cost effective concept of coated metal interconnects was developed, which resulted in 90% reduction in Cr evaporation, three times lower Cr2O3 scale thickness and increased lifetime. The possibility of assembling these cells into two radically different stack designs was demonstrated.
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