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1.
  • Ade, Peter, et al. (författare)
  • The Simons Observatory : science goals and forecasts
  • 2019
  • Ingår i: Journal of Cosmology and Astroparticle Physics. - : IOP Publishing. - 1475-7516. ; :2
  • Tidskriftsartikel (refereegranskat)abstract
    • The Simons Observatory (SO) is a new cosmic microwave background experiment being built on Cerro Toco in Chile, due to begin observations in the early 2020s. We describe the scientific goals of the experiment, motivate the design, and forecast its performance. SO will measure the temperature and polarization anisotropy of the cosmic microwave background in six frequency bands centered at: 27, 39, 93, 145, 225 and 280 GHz. The initial con figuration of SO will have three small-aperture 0.5-m telescopes and one large-aperture 6-m telescope, with a total of 60,000 cryogenic bolometers. Our key science goals are to characterize the primordial perturbations, measure the number of relativistic species and the mass of neutrinos, test for deviations from a cosmological constant, improve our understanding of galaxy evolution, and constrain the duration of reionization. The small aperture telescopes will target the largest angular scales observable from Chile, mapping approximate to 10% of the sky to a white noise level of 2 mu K-arcmin in combined 93 and 145 GHz bands, to measure the primordial tensor-to-scalar ratio, r, at a target level of sigma(r) = 0.003. The large aperture telescope will map approximate to 40% of the sky at arcminute angular resolution to an expected white noise level of 6 mu K-arcmin in combined 93 and 145 GHz bands, overlapping with the majority of the Large Synoptic Survey Telescope sky region and partially with the Dark Energy Spectroscopic Instrument. With up to an order of magnitude lower polarization noise than maps from the Planck satellite, the high-resolution sky maps will constrain cosmological parameters derived from the damping tail, gravitational lensing of the microwave background, the primordial bispectrum, and the thermal and kinematic Sunyaev-Zel'dovich effects, and will aid in delensing the large-angle polarization signal to measure the tensor-to-scalar ratio. The survey will also provide a legacy catalog of 16,000 galaxy clusters and more than 20,000 extragalactic sources.
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2.
  • Alloisio, Marta, et al. (författare)
  • Fracture of porcine aorta-Part 1 : symconCT fracture testing and DIC
  • 2023
  • Ingår i: Acta Biomaterialia. - : Elsevier BV. - 1742-7061 .- 1878-7568. ; 167, s. 147-157
  • Tidskriftsartikel (refereegranskat)abstract
    • Tissue failure and damage are inherent parts of vascular diseases and tightly linked to clinical events. Additionally, experimental set-ups designed to study classical engineering materials are suboptimal in the exploration of vessel wall fracture properties. The classical Compact Tension (CT) test was augmented to enable stable fracture propagation, resulting in the symmetry-constraint Compact Tension (symconCT) test, a suitable set-up for fracture testing of vascular tissue. The test was combined with Digital Image Correlation (DIC) to study tissue fracture in 45 porcine aorta specimens. Test specimens were loaded in axial and circumferential directions in a physiological solution at 37 & DEG;C. Loading the aortic vessel wall in the axial direction resulted in mode I tissue failure and a fracture path aligned with the circumferential vessel direction. Circumferential loading resulted in mode I-dominated failure with multiple deflections of the fracture path. The aorta ruptured at a principal Green-Lagrange strain of approximately 0.7, and strain rate peaks that develop ahead of the crack tip reached nearly 400 times the strain rate on average over the test specimen. It required approximately 70% more external work to fracture the aorta by circumferential than axial load; normalised with the fracture surface, similar energy levels are, however, observed. The symconCT test resulted in a stable fracture propagation, which, combined with DIC, provided a set-up for the in-depth analysis of vascular tissue failure. The high strain rates ahead of the crack tip indicate the significance of rate effects in the constitutive description of vascular tissue fracture.
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3.
  • Andersson, Mattias, et al. (författare)
  • Editor's Choice – Structured Computed Tomography Analysis can Identify the Majority of Patients at Risk of Post-Endovascular Aortic Repair Rupture
  • 2022
  • Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 64, s. 166-174
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The main objective was to report mechanisms and precursors for post-endovascular aneurysm repair (EVAR) rupture. The second was to apply a structured protocol to explore whether these factors were identifiable on follow up computed tomography (CT) prior to rupture. The third objective was to study the incidence, treatment, and outcome of post-EVAR rupture. Methods: This was a multicentre, retrospective study of patients treated with standard EVAR at five Swedish hospitals from 2008 to 2018. Patients were identified from the Swedvasc registry. Medical records were reviewed up to 2020. Index EVAR and follow up data were recorded. The primary endpoint was post-EVAR rupture. CT at follow up and at post-EVAR rupture were studied, using a structured protocol, to determine rupture mechanisms and identifiable precursors. Results: In 1 805 patients treated by EVAR, 45 post-EVAR ruptures occurred in 43 patients. The cumulative incidence was 2.5% over a mean follow up of 5.2 years. The incidence rate was 4.5/1 000 person years. Median time to post-EVAR rupture was 4.1 years. A further six cases of post-EVAR rupture in five patients found outside the main cohort were included in the analysis of rupture mechanisms only. The rupture mechanism was type IA in 20 of 51 cases (39%), IB in 20 of 51 (39%) and IIIA/B in 11 of 51 (22%). One of these had type IA + IB combined. One patient had an aortoduodenal fistula without another mechanism being identified. Precursors had been noted on CT follow up prior to post-EVAR rupture in 16 of 51 (31%). Retrospectively, using the structured protocol, precursors could be identified in 43 of 51 (84%). In 17 of 27 (63%) cases missed on follow up but retrospectively identifiable, the mechanisms were type IB/III. Overall, the 30 day mortality rate after post-EVAR rupture was 47% (n = 24/51) and the post-operative mortality rate was 21% (n = 7/33). Conclusions: Most precursors of post-EVAR rupture are underdiagnosed but identifiable before rupture using a structured follow up CT protocol. Precursors of type IB and III failures caused the majority of post-EVAR ruptures.
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4.
  • Bogdanovic, Marko, et al. (författare)
  • Limb Graft Occlusion Following Endovascular Aneurysm Repair for Infrarenal Abdominal Aortic Aneurysm with the Zenith Alpha, Excluder, and Endurant Devices : a Multicentre Cohort Study
  • 2021
  • Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier. - 1078-5884 .- 1532-2165. ; 62:4, s. 532-539
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Limb graft occlusion (LGO) is a serious complication after endovascular aneurysm repair (EVAR) and while device development enables treatment of increasingly complex aortic anatomy, little is known about how endograft type affects the risk of occlusion. This observational study aimed to explore the incidence of LGO after EVAR for three major endograft systems.Methods: All patients with standard EVAR as the primary intervention for infrarenal abdominal aortic aneurysm (AAA), between January 2012 and December 2018, at five Swedish vascular surgery centres, were included in this multicentre retrospective cohort study. LGO was defined as a total limb occlusion regardless of symptoms, or a treated significant stenosis. A nested case control (NCC) design with incidence density sampling of 1:3 was used for analysis of potential per-operative and morphological risk factors. Conditional logistic regression was used to estimate multivariable odds ratios (OR) with 95% confidence intervals (CI)Results: A total of 924 patients were included. The majority were male (84%), the mean age was 76 years (+/- 7.5 SD), and median AAA diameter was 59 mm (IQR 55, 67). Patients were treated with Zenith Alpha (n = 315, ZISL limbs), Excluder (n = 152, PLC/PXC limbs), and Endurant (n = 457, ETLW/ ETEW limbs). During median follow up of 37 months (IQR 21, 62), 55 occlusions occurred (5.9%); 39 with Zenith Alpha (12.4%), one with Excluder (0.7%), and 15 with Endurant (3.3%). In the NCC analysis, the Zenith Alpha device (OR 5.31, 95% CI 1.97 - 14.3), external iliac artery (EIA) landing (OR 5.91, 95% CI 1.30 - 26.7), and EIA diameter < 10 mm (OR 4.99, 95% CI 1.46 - 16.9) were associated with an increased risk of LGO.Conclusion: Endograft device type is an independent risk factor for LGO after EVAR. Specifically, the Zenith Alpha demonstrated an increased risk of LGO compared with the Endurant and Excluder devices. In addition, a narrow EIA and landing zone in EIA are also risk factors for LGO.
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5.
  • Fattahi, Nina, et al. (författare)
  • Prevalence of abdominal aortic aneurysm (AAA) in first-degree relatives : detecting AAA in adult offspring of AAA patients
  • 2024
  • Ingår i: BJS Open. - : Oxford University Press. - 2474-9842. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundFirst-degree relatives of patients with abdominal aortic aneurysm (AAA) may have an increased risk of developing the disease. The primary aim was to report the prevalence of AAA in adult male and female offspring of patients with AAA. The secondary aim was to explore the efficiency of a registry-based detection route, and the third aim was to report contemporary prevalence in the population.MethodsAdult offspring of individuals with AAA and matched controls were identified through national registries. The examination included questionnaires and ultrasound examinations of the infrarenal aorta. Aortic pathology was defined as an aortic diameter ≥25 mm, AAA ≥30 mm.ResultsThe participation rate among male and female adult offspring was 64% (350/543) and 69% (402/583), respectively. A lower participation rate was found in male and female controls (51% and 52%). No difference in prevalence of AAA was observed between male adult offspring and controls (0.9%, c.i. 0.2 to 2.3%) or in the female population (prevalence of 0.2% in adult offspring and controls). Aortic pathology and previously diagnosed AAA were detected in 5.3% (c.i. 3.3 to 8.0%) of male adult offspring and 2.3% (c.i. 1.1 to 4.2%) in controls. Aortic pathology was more prevalent among adult offspring of females with AAA.ConclusionThe prevalence of AAA in the general population is low, but aortic pathology is notably higher among male first-degree relatives. Increased awareness should be directed towards individuals with a possible hereditary predisposition, particularly offspring of females with AAA and older smokers. Risk factor-based targeted screening of adult offspring of patients with AAA after registry-based detection should be further explored.
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6.
  • Folkesson, Maggie, et al. (författare)
  • Proteolytically active ADAM10 and ADAM17 carried on membrane microvesicles in human abdominal aortic aneurysms
  • 2015
  • Ingår i: Thrombosis and Haemostasis. - : SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN. - 0340-6245 .- 2567-689X. ; 114:6, s. 1165-1174
  • Tidskriftsartikel (refereegranskat)abstract
    • The intraluminal thrombus (ILT) of human abdominal aortic aneurysm (AAA) has been suggested to damage the underlying aortic wall, but previous work found scant activity of soluble proteases in the abluminal layer of the ILT, adjacent to the aneurysm. We hypothesised that transmembrane proteases carried by membrane microvesicles (MV) from dying cells remain active in the abluminal ILT. ILTs and AAA segments collected from 21 patients during surgical repair were assayed for two major transmembrane proteases, ADAM10 (a disintegrin and metalloprotease-10) and ADAM17. We also exposed cultured cells to tobacco smoke and assessed ADAM10 and ADAM17 expression and release on MVs. Immunohistochemistry showed abundant ADAM10 and ADAM17 protein in the ILT and underlying aneurysmal aorta. Domain-specific antibodies indicated both transmembrane and shed ADAM17. Importantly, ADAM10 and ADAM 17 in the abluminal ILT were enzymatically active. Electron microscopy of abluminal ILT and aortic wall showed MVs with ADAM10 and ADAM17. By flow cytometry, ADAM-positive microvesicles from abluminal ILT carried the neutrophil marker CD66, but not the platelet marker CD61. Cultured HL60 neutrophils exposed to tobacco smoke extract showed increased ADAM10 and ADAM17 content, cleavage of these molecules into active forms, and release of MVs carrying mature ADAM10 and detectable ADAM17. In conclusion, our results implicate persistent, enzymatically active ADAMs on MVs in the abluminal ILT, adjacent to the aneurysmal wall. The production of ADAM10- and ADAM17-positive MVs from smoke-exposed neutrophils provides a novel molecular mechanism for the vastly accelerated risk of AAA in smokers.
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7.
  • Forsell, Caroline, et al. (författare)
  • The Quasi-Static Failure Properties of the Abdominal Aortic Aneurysm Wall Estimated by a Mixed Experimental-Numerical Approach
  • 2012
  • Ingår i: Annals of Biomedical Engineering. - : Springer-Verlag New York. - 0090-6964 .- 1573-9686. ; 41:7, s. 1554-1566
  • Tidskriftsartikel (refereegranskat)abstract
    • Assessing the risk for abdominal aortic aneurysm (AAA) rupture is critical in the management of aneurysm patients and an individual assessment is possible with the biomechanical rupture risk assessment. Such an assessment could potentially be improved by a constitutive AAA wall model that accounts for irreversible damage-related deformations. Because of that the present study estimated the elastic and inelastic properties of the AAA wall through a mixed experimental-numerical approach. Specifically, finite element (FE) models of bone-shaped tensile specimens were used to merge data from failure testing of the AAA wall with their measured collagen orientation distribution. A histo-mechanical constitutive model for collagen fibers was employed, where plastic fibril sliding determined not only remaining deformations but also weakening of the fiber. The developed FE models were able to replicate the experimentally recorded load-displacement property of all 16 AAA wall specimens that were investigated in the study. Tensile testing in longitudinal direction of the AAA defined a Cauchy strength of 569(SD 411) kPa that was reached at a stretch of 1.436(SD 0.118). The stiffness and strength of specimens decreased with the wall thickness and were elevated (p = 0.018; p = 0.030) in patients with chronic obstructive pulmonary disease (COPD). Smoking affected the tissue parameters that were related to the irreversible deformation response, and no correlation with gender and age was found. The observed effects on the biomechanical properties of the AAA wall could have long-term consequences for the management of aneurysm patients, i.e., specifically they might influence future AAA rupture risk assessments. However, in order to design appropriate clinical validation studies our findings should firstly be verified in a larger patient cohort.
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8.
  • Gasser, T. Christian, et al. (författare)
  • Collagen fiber orientation in Abdominal Aortic Aneurysms wall
  • 2010
  • Konferensbidrag (refereegranskat)abstract
    • Introduction Collagen is the most abundant protein in mammals and gives mechanical strength, stiffness and toughness to biological tissues like skin, tendon, bone, and vasculature [1]. Collagen fibrils of about 0.1 micrometers in diameters are the basic building blocks of fibrous collagenous tissues and their organization into suprafibrilar structures determines the tissue’s macroscopic mechanical properties. For example, detailed data regarding the organization of strong bundles of collagen might be critical to predict the onset of tissue failure, as it is clinically motivated by a rupture risk assessment of Abdominal Aortic Aneurysm (AAA). Previously proposed structural constitutive models for soft biological tissues [2, 3] integrated information regarding the collagen orientation, and regardless of their popularity, the requested microstructural information is not yet available in the open literature. Method and Materials The present study investigated the collagen formation in 12 AAA wall specimens stemming from 9 patients and harvested during elective aneurysm repair at Karolinska University Hospital, Stockholm, Sweden. Specimens of about 1.0 x 1.0 centimeter were squeezed between Plexiglas plates and fixated in formaldehyde for 24 hours. Fixated specimens were dehydrated and embedded in paraffin (Tissue Tek VIP 3000, Sakura)and sliced at a thickness of 7.0 micrometers (HM 360, Microm). To reinforce the birefringend properties of collagen the slices were stained with Picrus Sirius red before three-dimensional collagen fiber orientations were identified in a polarized light microscope (BX 50, Olympus) equipped with an Universal Rotary Stage (Zeiss). Specifically, the collagen orientations were measured at 36 points at each slice, where three slices across the thickness of the AAA wall were considered. The derived structural information was included in two different structural constitutive models and reported macroscopic mechanical data [4] was used to estimate mechanical parameters of the constitutive formulations. Results and Conclusions Collagen fiber orientation in the AAA wall is considerably spread out and no difference amongst medial and adventitial layers could be identified; a result in line with the layered structure of, e.g., cerebral aneurysms [5] but in clear contrast to the structural differences amongst the layers of normal arteries [6]. Collagen fibers in the AAA wall are predominantly aligned in circumferential direction, which might explain its higher stiffness along that direction [4]. Naturally, the complex collagen formation cannot be captured by a single (or two) families of collagen fibers and associated constitutive models are not applicable. Collagen turnover is thought to be mediated by the local stress or strain state [7] and the supra-physiological stresses in the AAA wall might cause the identified pathological collagen orientation. References [1] P. Fratzl, editor. Springer-Verlag, New York, 2008. [2] T. C. Gasser, et. al. J. R. Soc. Interface, 3:15–35, 2006. [3] S. Federico and T. C. Gasser. J. R.Soc. Interface, 2009. [4] J. P. Vande Geest et al.. J Biomech. 39, 1324--1334, 2006. [5] P. B. Canham, et al.. Neurological Res., 21, 618--626, 1999. [6] P. B. Canham, et al. Cardiovasc. Res. 23, 973-982, 1989. [7] J. D. Humphrey, Springer-Verlag, New York, 2002.
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9.
  • Gasser, T. Christian, et al. (författare)
  • Spatial orientation of collagen fibers in the abdominal aortic aneurysm's wall and its relation to wall mechanics
  • 2012
  • Ingår i: Acta Biomaterialia. - : Elsevier BV. - 1742-7061 .- 1878-7568. ; 8:8, s. 3091-3103
  • Tidskriftsartikel (refereegranskat)abstract
    • Collagen is the most abundant protein in mammals and provides the abdominal aortic aneurysm (AAA) wall with mechanical strength, stiffness and toughness. Specifically, the spatial orientation of collagen fibers in the wall has a major impact on its mechanical properties. Apart from valuable microhistological information, this data can be integrated by histomechanical constitutive models thought to improve biomechanical simulations, i.e. to improve the biomechanical rupture risk assessment of AAAs. Tissue samples (n = 24) from the AAA wall were harvested during elective AAA repair, fixated, embedded, sectioned and investigated by polarized light microscopy. The birefringent properties of collagen were reinforced by picrosirius red staining and the three-dimensional collagen fiber orientations were identified with a universal rotary stage. Two constitutive models for collagen fibers were used to integrate the identified structural information in a macroscopic AAA wall model. The collagen fiber orientation in the AM wall was widely dispersed and could be captured by a Bingham distribution function (kappa(1) = 11.6, kappa(2) = 9.7). The dispersion was much larger in the tangential plane than in the cross-sectional plane, and no significant difference between the medial and adventitial layers could be identified. The layered directional organization of collagen in normal aortas was not evident in the AAA. The collagen organization identified, combined with constitutive descriptions of collagen fibers that depend on its orientation, explain the anisotropic (orthotropic) mechanical properties of the AAA wall. The mechanical properties of collagen fibers depend largely on their undulation, which is an important structural parameter that requires further experimental investigation.
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10.
  • Gasser, T. Christian, et al. (författare)
  • The interaction of biochemical, biomechanical, and clinical factors of coronary disease
  • 2021
  • Ingår i: Biomechanics of Coronary Atherosclerotic Plaque. - : Elsevier BV. ; , s. 171-190
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Coronary heart disease is a major and global health care challenge, and its biomechanical analysis has been shown to be a useful complement in answering related clinical questions. Compelling evidence has been accumulated showing that two primary biomechanical factors predispose to the disease: low or oscillating wall shear stress and high wall mechanical stress (or strain) of plaque tissue components. While the level of sophistication with which vascular biomechanical analysis can be made has increased dramatically, the utility of biomechanical models in clinical practice remains very limited and their capability is by far not fully exploited. This chapter aims at reviewing the principles of the biomechanical analysis of coronary arteries in relation to the interplay of biomechanical, biochemical, and clinical factors. Techniques, methods, and modeling assumptions are discussed in relation to their clinical relevance, and thus toward the feasibility of translating research results and developing new treatment techniques and diagnostic tools.
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