| 1. |
- Spronk, H. M. H., et al.
(författare)
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Atherothrombosis and Thromboembolism : Position Paper from the Second Maastricht Consensus Conference on Thrombosis
- 2018
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Ingår i: Thrombosis and Haemostasis. - : SCHATTAUER GMBH-VERLAG MEDIZIN NATURWISSENSCHAFTEN. - 0340-6245 .- 2567-689X. ; 118:2, s. 229-250
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Forskningsöversikt (refereegranskat)abstract
- Atherothrombosis is a leading cause of cardiovascular mortality and long-term morbidity. Platelets and coagulation proteases, interacting with circulating cells and in different vascular beds, modify several complex pathologies including atherosclerosis. In the second Maastricht Consensus Conference on Thrombosis, this theme was addressed by diverse scientists from bench to bedside. All presentations were discussed with audience members and the results of these discussions were incorporated in the final document that presents a state-of-the-art reflection of expert opinions and consensus recommendations regarding the following five topics:1. Risk factors, biomarkers and plaque instability: In atherothrombosis research, more focus on the contribution of specific risk factors like ectopic fat needs to be considered; definitions of atherothrombosis are important distinguishing different phases of disease, including plaque (in) stability; proteomic and metabolomics data are to be added to genetic information.2. Circulating cells including platelets and atherothrombosis: Mechanisms of leukocyte and macrophage plasticity, migration, and transformation in murine atherosclerosis need to be considered; diseasemechanism-based biomarkers need to be identified; experimental systems are needed that incorporatewhole-blood flow to understand how red blood cells influence thrombus formation and stability; knowledge on platelet heterogeneity and priming conditions needs to be translated toward the in vivo situation.3. Coagulation proteases, fibrin(ogen) and thrombus formation: The role of factor (F) XI in thrombosis including the lower margins of this factor related to safe and effective antithrombotic therapy needs to be established; FXI is a key regulator in linking platelets, thrombin generation, and inflammatory mechanisms in a renin-angiotensin dependent manner; however, the impact on thrombin-dependent PAR signaling needs further study; the fundamental mechanisms in FXIII biology and biochemistry and its impact on thrombus biophysical characteristics need to be explored; the interactions of red cells and fibrin formation and its consequences for thrombus formation and lysis need to be addressed. Platelet-fibrin interactions are pivotal determinants of clot formation and stability with potential therapeutic consequences.4. Preventive and acute treatment of atherothrombosis and arterial embolism; novel ways and tailoring? The role of protease-activated receptor (PAR)-4 vis a vis PAR-1 as target for antithrombotic therapy merits study; ongoing trials on platelet function test-based antiplatelet therapy adjustment support development of practically feasible tests; risk scores for patients with atrial fibrillation need refinement, taking new biomarkers including coagulation into account; risk scores that consider organ system differences in bleeding may have added value; all forms of oral anticoagulant treatment require better organization, including education and emergency access; laboratory testing still needs rapidly available sensitive tests with short turnaround time.5. Pleiotropy of coagulation proteases, thrombus resolution and ischaemia-reperfusion: Biobanks specifically for thrombus storage and analysis are needed; further studies on novelmodified activated protein C-based agents are required including its cytoprotective properties; new avenues for optimizing treatment of patients with ischaemic stroke are needed, also including novel agents that modify fibrinolytic activity (aimed at plasminogen activator inhibitor-1 and thrombin activatable fibrinolysis inhibitor.
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| 2. |
- 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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| 3. |
- 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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| 4. |
- 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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| 5. |
- Blomström Lundqvist, Carina, et al.
(författare)
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Impact of non-adherence to direct oral anticoagulants amongst Swedish patients with non-valvular atrial fibrillation: results from a real-world cost-utility analysis
- 2022
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Ingår i: Journal of Medical Economics. - : Taylor & Francis. - 1369-6998 .- 1941-837X. ; 25:1, s. 1085-1091
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Tidskriftsartikel (refereegranskat)abstract
- Aims: A third of non-valvular atrial fibrillation (NVAF) patients are non-adherent to direct oral anticoagulants (DOACs). Estimates of the economic value of full adherence and the cost of two types of adherence improving interventions are important to healthcare planners and decision-makers.Methods: A cost-utility analysis estimated the impact of non-adherence over a 20-year horizon, for a patient cohort with a mean age of 77 years, based on data from the Stockholm Healthcare database of NVAF patients with incident stroke between 2011 and 2018. Adherence was defined using a medication possession ratio (MPR) cut-off of 90%; primary outcomes were the number of ischemic strokes and associated incremental cost–utility ratio.Results: Hypothetical comparisons between cohorts of 1,000 patients with varying non-adherence levels and full adherence (MPR >90%) predicted an additional number of strokes ranging from 117 (MPR = 81–90%) to 866 (MPR <60%), and years of life lost ranging from 177 (MPR = 81– 90%) to 1,318 (MPR < 60%; discounted at 3%). Chronic disease co-management intervention occurring during each DOAC prescription renewal and patient education intervention at DOAC initiation will be cost-saving to the health system if its cost is below SEK 143 and SEK 4,655, and cost-effective if below SEK 858 and SEK 28,665, respectively.Conclusion: Adherence improving interventions for NVAF patients on DOACs such as chronic disease co-management and patient education can be cost-saving and cost-effective, within a range of costs that appear reasonable to the Swedish healthcare system.
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| 6. |
- Frolov, Nikita, 1986, et al.
(författare)
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A SAT-Based Compiler for FlexCore
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Much like VLIW, statically scheduled architectures that expose all control signals to the compiler offer much potential for highly parallel, energy-efficient performance. Bau is a novel compilation infrastructure that leverages the LLVM compilation tools and the MiniSAT solver to generate efficient code for one such exposed architecture. We first build a compiler construction library that allows scheduling and resource constraints to be expressed declaratively in a domain-specific language, and then use this library to implement a compiler that generates programs that are 1.2–1.5 times more compact than either a baseline MIPS R2K compiler or a basic-block-based, sequentially phased scheduler.
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| 7. |
- Frolov, Nikita, 1986, et al.
(författare)
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Declarative, SAT-solver-based Scheduling for an Embedded Architecture with a Flexible Datapath
- 2011
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Ingår i: Swedish System-on-Chip Conference.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Much like VLIW, statically scheduled architectures that expose all control signals to the compiler offer much potential for highly parallel, energy-efficient performance. Bau is a novel compilation infrastructure that leverages the LLVM compilation tools and the MiniSAT solver to generate efficient code for one such exposed architecture. We first build a compiler construction library that allows scheduling and resource constraints to be expressed declaratively in a domain specific language, and then use this library to implement a compiler that generates programs that are 1.2–1.5 times more compact than either a baseline MIPS R2K compiler or a basic-block-based, sequentially phased scheduler.
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| 8. |
- Goel, Bhavishya, 1981, et al.
(författare)
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Infrastructures for Measuring Power
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Energy-aware resource management requires some means of measuring power consumption. We present three approaches to measuring processor power. The easiest, least intrusive places a power meter between the system and power outlet. Unfortunately, this provides a single system measurement, and acuity is limited by device sampling frequency. Another method samples power at PSU voltage outputs using current transducers. This logs consumption separately per component, but requires custom hardware and an expensive analog acquisition device. A more accurate alternative samples power directly at the processor voltage regulator’s current-sensing pin, but requires motherboard intrusion. We explain implementation of each approach step-by-step.
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| 9. |
- Goel, Bhavishya, 1981, et al.
(författare)
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Techniques to Measure, Model, and Manage Power
- 2012
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Ingår i: Advances in Computers. - 0065-2458. - 9780123965288 ; 87, s. 7-54
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Society's increasing dependence on information technology has resulted in the deployment of vast compute resources. The energy costs of operating these resources coupled with environmental concerns have made energy-aware computing one of the primary challenges for the IT sector. Making energy-efficient computing a rule rather than an exception requires that researchers and system designers use the right set of techniques and tools. These involve measuring, analyzing, and controlling the energy expenditure of computers at varying degrees of granularity. In this chapter, we present techniques to measure power consumption of computer systems at various levels and to compare their effectiveness. We discuss methodologies to estimate processor power consumption using performance-counter-based power modeling and show how the power models can be used for power-aware scheduling. Armed with such techniques and methodologies, we as a research and development community can better address challenges in power-aware management.
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| 10. |
- Goumas, Georgios, 1900, et al.
(författare)
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Adapt or Become Extinct!
- 2011
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Ingår i: Proceedings of the 1st International Workshop on Adaptive Self-Tuning Computing Systems for the Exaflop Era. - New York, NY, USA : ACM. - 9781450307086 ; , s. 46-51
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Konferensbidrag (refereegranskat)abstract
- The High-Performance Computing ecosystem consists of a large variety of execution platforms that demonstrate a wide diversity in hardware characteristics such as CPU architecture, memory organization, interconnection network, accelerators, etc. This environment also presents a number of hard boundaries (walls) for applications which limit software development (parallel programming wall), performance (memory wall, communication wall) and viability (power wall). The only way to survive in such a demanding environment is by adaptation. In this paper we discuss how dynamic information collected during the execution of an application can be utilized to adapt the execution context and may lead to performance gains beyond those provided by static information and compile-time adaptation. We consider specialization based on dynamic information like user input, architectural characteristics such as the memory hierarchy organization, and the execution profile of the application as obtained from the execution platform's performance monitoring units. One of the challenges of future execution platforms is to allow the seamless integration of these various kinds of information with information obtained from static analysis (either during ahead-of-time or just-in-time) compilation. We extend the notion of information-driven adaptation and outline the architecture of an infrastructure designed to enable information flow and adaptation through-out the life-cycle of an application.
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