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Sökning: WFRF:(Afshar S)

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  • Drake, Thomas M., et al. (författare)
  • Outcomes following small bowel obstruction due to malignancy in the national audit of small bowel obstruction
  • 2019
  • Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 45:12, s. 2319-2324
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology Introduction: Patients with cancer who develop small bowel obstruction are at high risk of malnutrition and morbidity following compromise of gastrointestinal tract continuity. This study aimed to characterise current management and outcomes following malignant small bowel obstruction. Methods: A prospective, multicentre cohort study of patients with small bowel obstruction who presented to UK hospitals between 16th January and 13th March 2017. Patients who presented with small bowel obstruction due to primary tumours of the intestine (excluding left-sided colonic tumours) or disseminated intra-abdominal malignancy were included. Outcomes included 30-day mortality and in-hospital complications. Cox-proportional hazards models were used to generate adjusted effects estimates, which are presented as hazard ratios (HR) alongside the corresponding 95% confidence interval (95% CI). The threshold for statistical significance was set at the level of P ≤ 0.05 a-priori. Results: 205 patients with malignant small bowel obstruction presented to emergency surgery services during the study period. Of these patients, 50 had obstruction due to right sided colon cancer, 143 due to disseminated intraabdominal malignancy, 10 had primary tumours of the small bowel and 2 patients had gastrointestinal stromal tumours. In total 100 out of 205 patients underwent a surgical intervention for obstruction. 30-day in-hospital mortality rate was 11.3% for those with primary tumours and 19.6% for those with disseminated malignancy. Severe risk of malnutrition was an independent predictor for poor mortality in this cohort (adjusted HR 16.18, 95% CI 1.86 to 140.84, p = 0.012). Patients with right-sided colon cancer had high rates of morbidity. Conclusions: Mortality rates were high in patients with disseminated malignancy and in those with right sided colon cancer. Further research should identify optimal management strategy to reduce morbidity for these patient groups.
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  • Vergallo, A., et al. (författare)
  • Association of plasma YKL-40 with brain amyloid-β levels, memory performance, and sex in subjective memory complainers
  • 2020
  • Ingår i: Neurobiology of Aging. - : Elsevier BV. - 0197-4580. ; 96, s. 22-32
  • Tidskriftsartikel (refereegranskat)abstract
    • Neuroinflammation, a key early pathomechanistic alteration of Alzheimer's disease, may represent either a detrimental or a compensatory mechanism or both (according to the disease stage). YKL-40, a glycoprotein highly expressed in differentiated glial cells, is a candidate biomarker for in vivo tracking neuroinflammation in humans. We performed a longitudinal study in a monocentric cohort of cognitively healthy individuals at risk for Alzheimer's disease exploring whether age, sex, and the apolipoprotein E ε4 allele affect plasma YKL-40 concentrations. We investigated whether YKL-40 is associated with brain amyloid-β (Aβ) deposition, neuronal activity, and neurodegeneration as assessed via neuroimaging biomarkers. Finally, we investigated whether YKL-40 may predict cognitive performance. We found an age-associated increase of YKL-40 and observed that men display higher concentrations than women, indicating a potential sexual dimorphism. Moreover, YKL-40 was positively associated with memory performance and negatively associated with brain Aβ deposition (but not with metabolic signal). Consistent with translational studies, our results suggest a potentially protective effect of glia on incipient brain Aβ accumulation and neuronal homeostasis. © 2020 Elsevier Inc.
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  • Vergallo, A., et al. (författare)
  • Plasma amyloid beta 40/42 ratio predicts cerebral amyloidosis in cognitively normal individuals at risk for Alzheimer's disease
  • 2019
  • Ingår i: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 15:6, s. 764-775
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Blood-based biomarkers of pathophysiological brain amyloid beta (A beta) accumulation, particularly for preclinical target and large-scale interventions, are warranted to effectively enrich Alzheimer's disease clinical trials and management. Methods: We investigated whether plasma concentrations of the A beta(1-40)/A beta(1-42) ratio, assessed using the single-molecule array (Simoa) immunoassay, may predict brain A beta positron emission tomography status in a large-scale longitudinal monocentric cohort (N = 276) of older individuals with subjective memory complaints. We performed a hypothesis-driven investigation followed by a no-apriori hypothesis study using machine learning. Results: The receiver operating characteristic curve and machine learning showed a balanced accuracy of 76.5% and 81%, respectively, for the plasma A beta(1-40)/A beta(1-42) ratio. The accuracy is not affected by the apolipoprotein E (APOE) epsilon 4 allele, sex, or age. Discussion: Our results encourage an independent validation cohort study to confirm the indication that the plasma A beta(1-40)/A beta(1-42) ratio, assessed via Simoa, may improve future standard of care and clinical trial design. (C) 2019 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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  • Sen, Partha, et al. (författare)
  • Novel FOXF1 Mutations in Sporadic and Familial Cases of Alveolar Capillary Dysplasia with Misaligned Pulmonary Veins Imply a Role for its DNA Binding Domain
  • 2013
  • Ingår i: Human Mutation. - : Hindawi Limited. - 1059-7794. ; 34:6, s. 801-811
  • Tidskriftsartikel (refereegranskat)abstract
    • Alveolar capillary dysplasia with misalignment of pulmonary veins (ACD/MPV) is a rare and lethal developmental disorder of the lung defined by a constellation of characteristic histopathological features. Nonpulmonary anomalies involving organs of gastrointestinal, cardiovascular, and genitourinary systems have been identified in approximately 80% of patients with ACD/MPV. We have collected DNA and pathological samples from more than 90 infants with ACD/MPV and their family members. Since the publication of our initial report of four point mutations and 10 deletions, we have identified an additional 38 novel nonsynonymous mutations of FOXF1 (nine nonsense, seven frameshift, one inframe deletion, 20 missense, and one no stop). This report represents an up to date list of all known FOXF1 mutations to the best of our knowledge. Majority of the cases are sporadic. We report four familial cases of which three show maternal inheritance, consistent with paternal imprinting of the gene. Twenty five mutations (60%) are located within the putative DNA-binding domain, indicating its plausible role in FOXF1 function. Five mutations map to the second exon. We identified two additional genic and eight genomic deletions upstream to FOXF1. These results corroborate and extend our previous observations and further establish involvement of FOXF1 in ACD/MPV and lung organogenesis.
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  • Ehteshami-Afshar, S., et al. (författare)
  • Clinical Characteristics and Outcomes of Patients With Heart Failure With Reduced Ejection Fraction and Chronic Obstructive Pulmonary Disease: Insights From PARADIGM-HF
  • 2021
  • Ingår i: Journal of the American Heart Association. - : Ovid Technologies (Wolters Kluwer Health). - 2047-9980. ; 10:4
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common comorbidity in heart failure with reduced ejection fraction, associated with undertreatment and worse outcomes. New treatments for heart failure with reduced ejection fraction may be particularly important in patients with concomitant COPD. METHODS AND RESULTS: We examined outcomes in 8399 patients with heart failure with reduced ejection fraction, according to COPD status, in the PARADIGM-HF (Prospective Comparison of Angiotensin Receptor Blocker-Neprilysin Inhibitor With Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) trial. Cox regression models were used to compare COPD versus non-COPD subgroups and the effects of sacubitril/valsartan versus enalapril. Patients with COPD (n=1080, 12.9%) were older than patients without COPD (mean 67 versus 63 years; P<0.001), with similar left ventricular ejection fraction (29.9% versus 29.4%), but higher NT-proBNP (N-terminal pro-B-type natriuretic peptide; median, 1741 pg/mL versus 1591 pg/mL; P=0.01), worse functional class (New York Heart Association III/IV 37% versus 23%; P<0.001) and Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (73 versus 81; P<0.001), and more congestion and comorbidity. Medical therapy was similar in patients with and without COPD except for beta-blockade (87% versus 94%; P<0.001) and diuretics (85% versus 80%; P<0.001). After multivariable adjustment, COPD was associated with higher risks of heart failure hospitalization (hazard ratio [HR], 1.32; 95% CI, 1.13-1.54), and the composite of cardiovascular death or heart failure hospitalization (HR, 1.18; 95% CI, 1.05-1.34), but not cardiovascular death (HR, 1.10; 95% CI, 0.94-1.30), or all-cause mortality (HR, 1.14; 95% CI, 0.99-1.31). COPD was also associated with higher risk of all cardiovascular hospitalization (HR, 1.17; 95% CI, 1.05-1.31) and noncardiovascular hospitalization (HR, 1.45; 95% CI, 1.29-1.64). The benefit of sacubitril/valsartan over enalapril was consistent in patients with and without COPD for all end points. CONCLUSIONS: In PARADIGM-HF, COPD was associated with lower use of beta-blockers and worse health status and was an independent predictor of cardiovascular and noncardiovascular hospitalization. Sacubitril/valsartan was beneficial in this high-risk subgroup. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01035255.
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  • Smith, ER, et al. (författare)
  • Adverse maternal, fetal, and newborn outcomes among pregnant women with SARS-CoV-2 infection: an individual participant data meta-analysis
  • 2023
  • Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite a growing body of research on the risks of SARS-CoV-2 infection during pregnancy, there is continued controversy given heterogeneity in the quality and design of published studies.MethodsWe screened ongoing studies in our sequential, prospective meta-analysis. We pooled individual participant data to estimate the absolute and relative risk (RR) of adverse outcomes among pregnant women with SARS-CoV-2 infection, compared with confirmed negative pregnancies. We evaluated the risk of bias using a modified Newcastle-Ottawa Scale.ResultsWe screened 137 studies and included 12 studies in 12 countries involving 13 136 pregnant women.Pregnant women with SARS-CoV-2 infection—as compared with uninfected pregnant women—were at significantly increased risk of maternal mortality (10 studies; n=1490; RR 7.68, 95% CI 1.70 to 34.61); admission to intensive care unit (8 studies; n=6660; RR 3.81, 95% CI 2.03 to 7.17); receiving mechanical ventilation (7 studies; n=4887; RR 15.23, 95% CI 4.32 to 53.71); receiving any critical care (7 studies; n=4735; RR 5.48, 95% CI 2.57 to 11.72); and being diagnosed with pneumonia (6 studies; n=4573; RR 23.46, 95% CI 3.03 to 181.39) and thromboembolic disease (8 studies; n=5146; RR 5.50, 95% CI 1.12 to 27.12).Neonates born to women with SARS-CoV-2 infection were more likely to be admitted to a neonatal care unit after birth (7 studies; n=7637; RR 1.86, 95% CI 1.12 to 3.08); be born preterm (7 studies; n=6233; RR 1.71, 95% CI 1.28 to 2.29) or moderately preterm (7 studies; n=6071; RR 2.92, 95% CI 1.88 to 4.54); and to be born low birth weight (12 studies; n=11 930; RR 1.19, 95% CI 1.02 to 1.40). Infection was not linked to stillbirth. Studies were generally at low or moderate risk of bias.ConclusionsThis analysis indicates that SARS-CoV-2 infection at any time during pregnancy increases the risk of maternal death, severe maternal morbidities and neonatal morbidity, but not stillbirth or intrauterine growth restriction. As more data become available, we will update these findings per the published protocol.
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  • Arman, S.Y., et al. (författare)
  • Evaluation of nanostructured S-doped TiO2 thin films and their photoelectrochemical application as photoanode for corrosion protection of 304 stainless steel
  • 2014
  • Ingår i: Surface & Coatings Technology. - : Elsevier BV. - 0257-8972 .- 1879-3347. ; 251, s. 162-169
  • Tidskriftsartikel (refereegranskat)abstract
    • Undoped and S-doped TiO2 thin films were prepared on titanium substrate through a sol–gel method. The photoelectrochemical behavior of S-doped TiO2 thin film (as photoanode) was studied. The effect of Sulfur doping on structural, optical and morphological properties of TiO2 was studied by X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), FT-IR, UV–ViS and FE-SEM. Superiority of the S-doped TiO2 film was shown through taking advantage of linear sweep voltametry measurement, open-circuit potential of 304 stainless steel as well as potetiodynamic polarization technique. Results showed that S-doped TiO2 thin film is an efficient photoanode with long term stability (several hours).
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  • Balasubramanian, S.M.N, et al. (författare)
  • A dual shared stack for FSLM in Erika enterprise
  • 2017
  • Ingår i: The 23rd IEEE International Conference on Embedded and Real-Time Computing Systems and Applications - WiP Session RTCSA'17.
  • Konferensbidrag (refereegranskat)abstract
    • Recently, the flexible spin-lock model (FSLM) has been introduced, unifying spin-based and suspension-based resource sharing protocols for real-time multi-core platforms. Unlike the multiprocessor stack resource policy (MSRP), FSLM doesn’t allow tasks on a core to share a single stack, however. In this paper, we present a hypothesis claiming that for a restricted range of spin-lock priorities, FSLM requires only two stacks. We briefly describe our implementation of a dual stack for FSLM in the Erika Enterprise RTOS as instantiated on an Altera Nios II platform using 4 soft-core processors.
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  • Balasubramanian, S.M.N, et al. (författare)
  • Incorporating implementation overheads in the analysis for the flexible spin-lock model
  • 2017
  • Ingår i: IECON 2017 - 43RD ANNUAL CONFERENCE OF THE IEEE INDUSTRIAL ELECTRONICS SOCIETY. - 9781538611272 ; , s. 411-8418
  • Konferensbidrag (refereegranskat)abstract
    • The flexible spin-lock model (FSLM) unifies suspension-based and spin-based resource sharing protocols for partitioned fixed-priority preemptive scheduling based real-time multiprocessor platforms. Recent work has been done in defining the protocol for FSLM and providing a schedulability analysis without accounting for the implementation overheads. In this paper, we extend the analysis for FSLM with implementation overheads. Utilizing an initial implementation of FSLM in the OSEK/VDX-compliant Erika Enterprise RTOS on an Altera Nios II platform using 4 soft-core processors, we present an improved implementation. Given the design of the implementation, the overheads are characterized and incorporated in specific terms of the existing analysis. The paper also supplements the analysis with measurement results, enabling an analytical comparison of FSLM with the natively provided multiprocessor stack resource policy (MSRP), which may serve as a guideline for the choice of FSLM or MSRP for a specific application.
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  • Balasubramanian, S. M. N., et al. (författare)
  • Practical challenges for FSLM
  • 2018
  • Ingår i: Proceedings - 2018 IEEE 24th International Conference on Embedded and Real-Time Computing Systems and Applications, RTCSA 2018. - : Institute of Electrical and Electronics Engineers Inc.. - 9781538677599 ; , s. 238-239
  • Konferensbidrag (refereegranskat)abstract
    • The flexible spin-lock model (FSLM) unifies suspension-based and spin-based resource access protocols for partitioned fixed-priority preemptive scheduling based real-time multi-core platforms. Recent work has been done in defining the protocol for FSLM, providing schedulability analysis, and investigating the practical consequences of the theoretical model. FSLM complies to the AUTOSAR standard for the automotive industry, and prototype implementations of FSLM in the OSEK/VDX-complaint Erika Enterprise Real-Time Operating System have been realized. In this paper, we briefly describe some practical challenges to improve efficiency and generality. 
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  • Houtan, Bahar, 1989-, et al. (författare)
  • Schedulability Analysis of Best-Effort Traffic in TSN Networks
  • 2021
  • Ingår i: IEEE International Conference on Emerging Technologies and Factory Automation, ETFA. - : Institute of Electrical and Electronics Engineers (IEEE). - 9781728129891
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • This paper presents a schedulability analysis for the Best-Effort (BE) traffic class within Time-Sensitive Networking (TSN) networks. The presented analysis considers several features in the TSN standards, including the Credit-Based Shaper (CBS), the Time-Aware Shaper (TAS), and the frame preemption. Although the BE class in TSN is primarily used for the traffic with no strict timing requirements, some industrial applications prefer to utilize this class for the non-hard real-time traffic instead of classes that use the CBS. The reason mainly lies in the fact that the complexity of TSN configuration becomes significantly high when the time-triggered traffic via the TAS and other classes via the CBS are used altogether. We demonstrate the applicability of the presented analysis on a vehicular application use case. We show that a network designer can get information on the schedulability of the BE traffic, based on which the network configuration can be further refined with respect to the application requirements. 
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