| 1. |
- Ridderstolpe, Lisa, et al.
(författare)
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Risk factor analysis of early and delayed cerebral complications after cardiac surgery
- 2002
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Ingår i: Journal of Cardiothoracic and Vascular Anesthesia. - : Elsevier. - 1053-0770 .- 1532-8422. ; 16:3, s. 278-285
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To report the incidence, severity, and possible risk factors for early and delayed cerebral complications.Design: Retrospective study.Setting: Linköping University Hospital, Sweden.Participants: Consecutive patients who underwent cardiac surgery in the period July 1996 through June 2000 (n = 3,282).Interventions: A standard cardiopulmonary bypass (CPB) technique was used for most patients. Postoperative anticoagulant treatment included heparin or anti-Xa dalteparin. Patients undergoing coronary artery bypass graft surgery received acetylsalicylic acid, and patients undergoing valve surgery received warfarin.Measurements and Main Results: Cerebral complications occurred in 107 patients (3.3%). Of these, 60 (1.8%) were early, and 33 (1.0%) were delayed, and in 14 (0.4%) patients the onset was unknown. There were 37 variables in univariate analysis (p < 0.15) and 14 variables in multivariate analysis (p < 0.05) associated with cerebral complications. Predictors of early cerebral complications were older age, preoperative hypertension, aortic aneurysm surgery, prolonged CPB time, hypotension at CPB completion and soon after CPB, and postoperative arrhythmia and supraventricular tachyarrhythmia. Predictors of delayed cerebral complications were female gender, diabetes, previous cerebrovascular disease, combined valve surgery and coronary artery bypass graft surgery, postoperative supraventricular tachyarrhythmia, and prolonged ventilator support. Early cerebral complications seem to be more serious, with more permanent deficits and a higher overall mortality (35.0% v 18.2%).Conclusion: Most cerebral complications had an early onset. The results of this study suggest that aggressive antiarrhythmic treatment and blood pressure control may imfurther prove the cerebral outcome after cardiac surgery.
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| 2. |
- Adolfsson, Jan, et al.
(författare)
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Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005 : Data from the national prostate cancer register in Sweden
- 2007
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Ingår i: Scandinavian Journal of Urology and Nephrology. - Stockholm : Taylor & Francis. - 0036-5599 .- 1651-2065. ; 41:6, s. 456-477
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of >100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score ≤6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged ≥75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. Conclusions. All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer
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| 3. |
- Adolfsson, Jan, et al.
(författare)
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Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005
- 2007
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Ingår i: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 0036-5599 .- 1651-2065. ; 41:6, s. 456-477
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. MATERIAL AND METHODS: Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. RESULTS: In total, 72,028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of > 100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score <6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged > or =75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. CONCLUSIONS: All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer.
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| 4. |
- Ahlgren, Ewa, et al.
(författare)
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Driving performance of patients with coronary artery disease
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives To compare patients with coronary artery disease and healthy controls with respect to cognitive function and driving performance.Design and setting A controlled study conducted between April 1999 and January 2001.Subjects Forty-four patients with stable coronary artery disease scheduled for cardiac intervention with coronary artery bypass surgery or percutaneous coronary intervention. Forty volunteers of similar age without symptoms of coronary artery disease served as controls.Main outcome measures On-road driving scores in five specific test areas with a rating scale from 1 to 5. Neuropsychological test scores, including 12 tests.Results Compared with controls, patients with coronary artery disease had lower scores in all areas of the on-road driving test (p<0.05) and in the neuropsychological tests assessing psychomotor speed, visual and verbal memory, focused attention and simultaneous capacity (p<0.05). The difference between the groups in the on-road driving test appeared to be more pronounced among those above 65 years-of-age. Both patients and controls rated their performance significantly higher than the traffic inspector (p<0.05).Conclusions Cognitive function and driving performance may be impaired in patients with coronary artery disease.
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| 5. |
- Ahlgren, Ewa, 1959-, et al.
(författare)
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Neurocognitive impairment and driving performance after coronary artery bypass surgery
- 2003
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Ingår i: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 23:3, s. 334-340
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Neurocognitive impairment is common after cardiac surgery but few studies have examined the relationship between postoperative neuropsychological test performance and everyday behavior. The influence of postoperative cognitive impairment on car driving has previously not been investigated. The purpose of this study was to evaluate neurocognitive function and driving performance after coronary artery bypass grafting (CABG).Methods: Twenty-seven patients who underwent coronary artery bypass grafting with standard cardiopulmonary bypass technique and 20 patients scheduled for percutaneous coronary intervention (PCI) under local anesthesia (control group) were enrolled in this prospective study conducted from April 1999 to September 2000. Complete data were obtained in 23 and 19 patients, respectively. The patients underwent neuropsychological examination with a test battery including 12 tests, a standardized on-road driving test and a test in an advanced driving simulator before and 4–6 weeks after intervention.Results: More patients in the coronary artery bypass grafting group (n=11, 48%) than in the percutaneous coronary intervention group (n=2, 10%) showed a cognitive decline after intervention (P=0.01). In the on-road driving test, patients who underwent coronary artery bypass grafting deteriorated after surgery in the cognitive demanding parts like traffic behavior (P=0.01) and attention (P=0.04). Patients who underwent percutaneous intervention deteriorated in maneuvering of the vehicle (P=0.04). No deterioration was detected in the simulator in any of the groups after intervention. Patients with a cognitive decline after intervention also tended to drop in the on-road driving scores to a larger extent than did patients without a cognitive decline.Conclusion: This study indicates that cognitive functions important for safe driving may be influenced after cardiac surgery.
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| 6. |
- Ahlgren, Ewa, 1959-, et al.
(författare)
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Patients with Coronary Artery Disease Are Active Car Drivers Both Before and Soon After Heart Surgery
- 2002
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Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 3:3, s. 205-208
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive ability is essential for the fitness to drive. Impaired cognitive functions are common after cardiac surgery. Little is known about driving habits and influence of postoperative cognitive decline on driving performance in these patients. The aim of this study was to investigate the extent of driving activity of patients before and after cardiac surgery. Ninety-seven cardiac surgical patients were interviewed about their driving habits before and 12 weeks after surgery. The mean age was 66. Before the operation, 78% were active car drivers. They drove several times a week including longer than 100 km distances. After the operation, 64% continued to drive and most of them (69%) had commenced driving within 6 weeks. The majority (79%) reported unchanged driving habits, while 13 patients (21%) had reduced their driving activity due to the cognitive symptoms they experienced. Patients with coronary artery disease are active car drivers both before and after heart surgery. Further evaluation of the ability of these patients to drive is required if we are to give advice and apply restrictions in the interest of traffic safety.
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| 7. |
- AHLGREN, GÖRAN, et al.
(författare)
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Impaired Secretory Function of the Prostate in Men With Oligo‐Asthenozoospermia
- 1995
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Ingår i: Journal of Andrology. - 0196-3635. ; 16:6, s. 491-498
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: The secretory function of the human prostate and the seminal vesicles is a prerequisite for gel formation and liquefaction of semen, but the relation to poor sperm motility and low sperm count in infertile men remains to be clarifyed. Our aim was to evaluate the secretory function of the prostate and the seminal vesicles in normozoospermic men (n=35) and in asthenozoospermic men, who were all also oligozoospermic (n=27). All 62 subjects belonged to couples undergoing routine infertility evaluation. In liquefied seminal fluid we measured the concentrations of fructose and protein C inhibitor (PCI) contributed by the seminal vesicles, PCI complexed to prostate‐specific antigen (PSA), and the prostatic contribution of zinc, PSA, acid phosphatase (PAP), β‐microseminoprotein (β‐MSP), and Znα2‐glycoprotein (Znα2‐GP). The concentration of each prostatic secretory protein correlated significantly with that of zinc (P < 0.01) in both the normozoospermic (NZS) and oligo‐astheno‐zoospermic (OAZS) subgroups, but the PCI concentration did not correlate significantly with that of fructose. There was no significant difference between the NZS and OAZS subgroups in ejaculate volume or secretory contribution from the seminal vesicles, whereas the OAZS subgroup was characterized by significantly lower secretory contributions of Znα2‐GP (P = 0.001), Zn, PSA, PAP (P < 0.01), and β‐MSP (P < 0.05). The two subgroups did not differ significantly in the serum concentration of luteinizing hormone (LH), testosterone, or sex hormone‐binding globulin (SHBG). The results thus suggest the secretory contribution of major prostatic proteins and zinc per ejaculate to be significantly decreased in oligo‐asthenozoospermic men. The importance of this finding in relation to poor sperm count and motility as indicators of impaired gonadal function requires further investigation. 1995 American Society of Andrology
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| 8. |
- Ahlgren, Hans, et al.
(författare)
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Multiple prehistoric introductions of the mountain hare (Lepus timidus) on a remote island, as revealed by ancient DNA
- 2016
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Ingår i: Journal of Biogeography. - : Wiley. - 0305-0270 .- 1365-2699. ; 43:9, s. 1786-1796
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The majority of the non-volant mammals now present on the island of Gotland, Sweden, have been introduced in modern times. One exception is the mountain hare (Lepus timidus), which was present on the island more than 9000 years ago. This paper investigates the origins of the Gotland hares and temporal changes in their genetic structure, and considers how they may have reached the island.Location: The island of Gotland, Sweden (57°30′ N, 18°20′ E).Methods: Two fragments of the mitochondrial D-loop 130 + 164 base pairs in length from skeletal remains from 40 ancient mountain hares from Gotland, 38 from the Swedish mainland and five from Lithuania were analysed and compared with 90 modern L. timidus haplotypes from different locations in Eurasia and five haplotypes of the Don-hare (Lepus tanaiticus) morphotype.Results: The Mesolithic hares from Gotland (7304 bc–5989 bc) cluster with modern hares from Russia, Scotland, the Alps and Fennoscandia whereas the Gotland hares from the Neolithic and onwards (2848 bc–1641 ad) cluster with Neolithic hares from the Swedish mainland and modern hares from Fennoscandia. The Neolithic haplotypes from Lithuania and the Don-hare haplotypes were dispersed within the network. The level of differentiation (FST) between the Mesolithic and Neolithic hares on Gotland was twice as great as that observed on the mainland.Main conclusions: The ancient hares on Gotland fall into two haplogroups separated in time, indicating that the mountain hare became extinct at one point, with subsequent re-colonization events. In view of the isolated location of Gotland, it is probable that the hares were brought there by human means of transport.
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| 9. |
- Ahlgren, Hans, 1984-
(författare)
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Prehistoric human impact on wild mammalian populations in Scandinavia
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis aims to study the interactions of pre-agricultural societies in Scandinavia with wild mammals, for example in terms of hunting and translocation. More specifically, the aim is to investigate the possibility of identifying examples of overexploitation, targeted hunting or translocation of wild mammals in prehistoric Scandinavia, and to discuss the implications this could have had for both the wild animals and the humans. The thesis also studies translocation to evaluate the feasibility of using it as a proxy for prehistoric human mobility, and to understand the motivation for this action. Although the focus is on the animals in this thesis, the ultimate purpose is to study humans and their interactions with animals in prehistory. The thesis applies genetic analyses to zooarchaeological material of various mammalian species from different Scandinavian sites, in order to study whether the genetic structures have changed in these species over time, and to assess whether these changes were induced by different human actions. The species studied in this thesis were selected on the basis of the importance they are considered to have had for prehistoric people.The dissertation comprises five studies. The first study investigates the occurrence of mountain hares on the island of Gotland, and discusses how they got there and where they came from. The second study explores the temporal genetic structure of the grey seal in the Baltic Sea, and discusses whether humans and/or climate were the drivers for the sudden disappearance of grey seals from the island of Stora Karlsö. The third study concerns a shift where moose apparently became less important as prey in northern Sweden at the end of the Neolithic period, and discusses whether humans targeted female moose in hunting. The fourth study analyses and discusses the history of the harp seal in the Baltic Sea. The fifth study is a methodological paper which involves identifying seals according to sex, using the dog genome.The overall result of the different case studies shows that there were major population fluctuations over time in all the species studied, and that in some cases, humans are likely to have contributed to this, e.g. through overhunting and translocation. The study also shows that the population fluctuations often occurred in connection with certain climatic events, though it was not possible to separate climatic effects from human impact in terms of the cause.
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| 10. |
- Ahlgren, Hans, 1984-, et al.
(författare)
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The Baltic grey seal : A 9000-year history of presence and absence
- 2022
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Ingår i: The Holocene. - : SAGE Publications. - 0959-6836 .- 1477-0911. ; 32:6, s. 569-577
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Tidskriftsartikel (refereegranskat)abstract
- The grey seal (Halichoerus grypus) has been part of the Baltic Sea fauna for more than 9000 years and has ever since been subjected to extensive human hunting, particularly during the early phases of its presence in the Baltic Sea, but also in the early 20th century. In order to study their temporal genetic structure and to investigate whether there has been a genetically continuous grey seal population in the Baltic, we generated mitochondrial control region data from skeletal remains from ancient grey seals from the archaeological sites Stora Förvar (Sweden) and Neustadt (Germany) and compared these with modern grey seal data. We found that the majority of the Mesolithic grey seals represent haplotypes that is not found in contemporary grey seals, indicating that the Baltic Sea population went extinct, likely due to human overexploitation and environmental change. We hypothesize that grey seals recolonised the Baltic Sea from the North Sea. during the Bronze Age or Iron Age, and that the contemporary Baltic grey seal population is direct descendants of this recolonisation. Our study highlights the power of biomolecular archaeology to understand the factors that shape contemporary marine diversity.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Ahlgren, Jennie, et al.
(författare)
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Consumers on the Internet : ethical and legal aspects of commercialization of personalized nutrition
- 2013
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Ingår i: Genes & Nutrition. - : Springer. - 1555-8932 .- 1865-3499. ; 8:4, s. 349-355
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Forskningsöversikt (refereegranskat)abstract
- Consumers often have a positive attitude to the option of receiving personalized nutrition advice based upon genetic testing, since the prospect of enhancing or maintaining one’s health can be perceived as empowering. Current direct-to-consumer services over the Internet, however, suffer from a questionable level of truthfulness and consumer protection, in addition to an imbalance between far-reaching promises and contrasting disclaimers. Psychological and behavioral studies indicate that consumer acceptance of a new technology is primarily explained by the end user’s rational and emotional interpretation as well as moral beliefs. Results from such studies indicate that personalized nutrition must create true value for the consumer. Also, the freedom to choose is crucial for consumer acceptance. From an ethical point of view, consumer protection is crucial, and caution must be exercised when putting nutrigenomic-based tests and advice services on the market. Current Internet offerings appear to reveal a need to further guaranty legal certainty by ensuring privacy, consumer protection and safety. Personalized nutrition services are on the borderline between nutrition and medicine. Current regulation of this area is incomplete and undergoing development. This situation entails the necessity for carefully assessing and developing existing rules that safeguard fundamental rights and data protection while taking into account the sensitivity of data, the risks posed by each step in their processing, and sufficient guarantees for consumers against potential misuse.
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| 15. |
- Albin, Maria, et al.
(författare)
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Cytogenetic and morphologic subgroups of myelodysplastic syndromes in relation to occupational and hobby exposures.
- 2003
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 29:5, s. 378-387
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study investigated the association between occupational and hobby exposure and the risk of myelodysplastic syndromes (MDS) while focusing on differential patterns of clonal chromosome aberrations and morphologic subgroups. METHODS: A case-referent study was conducted with 330 MDS patients investigated cytogenetically in 1976-1993 (cases) and matched referents. Telephone interviews with either the person or a next-of-kin were used. The participation rate of the cases and referents was 85% and 60%, respectively. Information was obtained from the next-of-kin more often for the cases (88%) than for the referents (26%). Occupational hygienists assessed the exposure using interview data on worktasks and hobbies. Associations with disease risk were evaluated for 10 exposures with a logistic regression analysis. RESULTS: The investigated exposures were generally not associated with cytogenetically abnormal MDS. Effect estimates for specific cytogenetic or morphologic subgroups were generally imprecise. Occupational exposure to extremely low-frequency magnetic fields (EMF) was associated with MDS with a normal karyotype [odds ratio (OR) 2.0, 95% confidence interval (95% CI) 1.0-4.0]. The exposure-response association was consistent for intensity but inconclusive for duration. A decreased risk was observed for MDS, irrespective of karyotypic pattern, among farmers and farmhands (OR 0.53, 95% CI 0.35-0.81). CONCLUSIONS: Cytogenetically abnormal MDS was generally not associated with occupational or hobby exposure to known or suspected genotoxic agents. However, exposure prevalences and intensities were low for several agents. An association was suggested between occupational exposure to EMF and MDS with a normal karyotype. Biases due to differential information quality and selective participation cannot be ruled out.
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Björk, Jonas, et al.
(författare)
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Are occupational, hobby, or lifestyle exposures associated with Philadelphia chromosome positive chronic myeloid leukaemia?
- 2001
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 58:11, s. 722-727
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate a broad range of occupational, hobby, and lifestyle exposures, suggested as risk factors for Philadelphia chromosome positive (Ph+) chronic myeloid leukaemia (CML). METHODS: A case-control study, comprising 255 Ph+CML patients from southern Sweden and matched controls, was conducted. Individual data on work tasks, hobbies, and lifestyle exposures were obtained by telephone interviews. Occupational hygienists assessed occupational and hobby exposures for each subject individually. Also, occupational titles were obtained from national registries, and group level exposure-that is, the exposure proportion for each occupational title-was assessed with a job exposure matrix. The effects of 11 exposures using individual data and two exposures using group data (organic solvents and animal dust) were estimated. RESULTS: For the individual data on organic solvents, an effect was found for moderate or high intensity of exposure (odds ratio (OR) 3.4, 95% confidence interval (95% CI) 1.1 to 11) and for long duration (15-20 years) of exposure (OR 2.1, 95% CI 1.1 to 4.0). By contrast, the group data showed no association (OR 0.69, 95% CI 0.27 to 1.8; moderate or high intensity versus no exposure). For extremely low frequency electromagnetic fields (EMFs), only individual data were available. An association with long occupational exposure to EMFs was found (OR 2.3, 95% CI 1.2 to 4.5). However, no effect of EMF intensity was indicated. No significant effects of benzene, gasoline or diesel, or tobacco smoking were found. OR estimates below unity were suggested for personal use of hair dye and for agricultural exposures. CONCLUSIONS: Associations between exposure to organic solvents and EMFs, and Ph+CML were indicated but were not entirely consistent.
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| 20. |
- Bombarda, F., et al.
(författare)
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Runaway electron beam control
- 2019
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Ingår i: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 1361-6587 .- 0741-3335. ; 61:1
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Tidskriftsartikel (refereegranskat)
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| 21. |
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| 22. |
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| 23. |
- Bro-Jørgensen, Maiken Hemme, et al.
(författare)
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Genomic insights on the extinct Baltic harp seal population
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The harp seal is a cold adapted seal species, which requires a suitable formation of pack ice during winter and spring to secure successfully breeding. Today harp seals live in sub-Arctic regions and the North Atlantic, but during the middle Holocene Period, a breeding population existed in the Baltic Sea. In order to investigate the genetic affinity and faith of the now extinct Baltic harp seal population we analysed contemporary and ancient mitogenomes from across the species contemporary and ancient range. Ancient mitochondrial genomes were generated for a total of 49 Baltic harp seals ranging from Late Mesolithic to the Iron Age, together with five Neolithic samples from the White Sea and two Neolithic samples from the Northwest Atlantic Ocean. The ancient data was compared to published modern harp seal data assigned to the present breeding populations around Newfoundland, the Greenland Sea and the White Sea. Surprisingly only limited phylogenetic resolution was found among the ancient and modern localities. The statistical measures for genetic differentiation, however, identified significant levels of population genetic differentiation between the Baltic harp seal population and all modern populations, which suggest an independent breeding population in the Baltic Sea. The low level of genetic differentiation to the White Sea population indicate a shared ancestry between the Baltic and White Sea. The generated Skyline plot suggest second wave of colonization after a hiatus in the Baltic Sea. Interestingly, the genetic diversity in the Baltic harp seal population was significantly higher than in any of the modern populations. However, a drastic decrease in genetic diversity is observed from the Bronze Age to the Iron Age, which might be linked to effects of high hunting pressure and climatic changes towards the final extirpation of harp seals in the Baltic.
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| 24. |
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| 25. |
- Bydén, Moa, et al.
(författare)
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Cerebrovascular Reserve Capacity as a Predictor of Postoperative Delirium : A Pilot Study
- 2021
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Ingår i: Frontiers in Surgery. - : Frontiers Media S.A.. - 2296-875X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Postoperative delirium is a common complication after cardiac surgery with cardiopulmonary bypass (CPB). Compromised regulation of the cerebral circulation may be a predisposing factor for delirium. However, the potential relationship between cerebrovascular reserve capacity and delirium is unknown. The aim of this study was to investigate if impaired cerebrovascular reserve capacity was associated with postoperative delirium.Methods: Forty-two patients scheduled for cardiac surgery with CPB were recruited consecutively. All patients underwent preoperative transcranial Doppler (TCD) ultrasound with calculation of breath-hold index (BHI). BHI < 0.69 indicated impaired cerebrovascular reserve capacity. In addition, patients were examined with preoperative neuropsychological tests such as MMSE (Mini Mental State Examination) and AQT (A Quick Test of cognitive speed). Postoperative delirium was assessed using Nursing Delirium Screening Scale (Nu-DESC) in which a score of >= 2 was considered as delirium.Results: Six patients (14%) scored high for postoperative delirium and all demonstrated impaired preoperative cerebrovascular reserve capacity. Median (25th-75th percentile) BHI in patients with postoperative delirium was significantly lower compared to the non-delirium group [0.26 (-0.08-0.44) vs. 0.83 (0.57-1.08), p = 0.002]. Preoperative MMSE score was lower in patients who developed postoperative delirium (median, 25th-75th percentile; 26.5, 24-28 vs. 28.5, 27-29, p = 0.024). Similarly, patients with postoperative delirium also displayed a slower performance during the preoperative cognitive speed test AQT color and form (mean +/- SD; 85.8 s +/- 19.3 vs. 69.6 s +/- 15.8, p = 0.043).Conclusion: The present findings suggest that an extended preoperative ultrasound protocol with TCD evaluation of cerebrovascular reserve capacity and neuropsychological tests may be valuable in identifying patients with increased risk of developing delirium after cardiac surgery.
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| 26. |
- Cinthio, Magnus, et al.
(författare)
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A Method for Arterial Diameter Change Measurements Using Ultrasonic B-Mode Data.
- 2010
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Ingår i: Ultrasound in Medicine and Biology. - : Elsevier BV. - 0301-5629. ; 36:9, s. 1504-1512
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Tidskriftsartikel (refereegranskat)abstract
- Arterial diameter change is related to distending blood pressure and is used in estimation of arterial stiffness parameters. A common technique to track the arterial walls is by integration of wall velocities estimated by different methods using cross correlation or tissue Doppler. However, because of the high pulse repetition frequency and the need for separate pulsing sequences, the B-mode image quality is affected. We have previously developed a fast algorithm for direct measurement of lumen diameter using B-mode images. In this study we have improved the technique to be more robust and also implemented measurements of diameter change, maximum differential wall velocity and relative diameter change of the common carotid artery noninvasively in vivo. The influence of the lateral width of the region of interest (ROI; 1 pixel, 0.1 mm, 0.5 mm, 1 mm, 2.5 mm and 5 mm) was evaluated. Using the optimal lateral width (2.5 mm), the systematic and random differences between two consecutive measurements were 21 mum and 105 mum, respectively, for lumen diameter measurement; -7 mum and 39 mum, respectively, for lumen diameter change measurements; -0.2 mm/s and 0.9 mm/s, respectively, for maximum relative wall velocity; and -0.2 % and 0.8 %, respectively, for measurements of the relative diameter change. The coefficient of variation (CV) was 1.9%, 5.2%, 7.9% and 6.0%, respectively. The study indicates that the reproducibility is sufficient for in vivo studies when the width of the ROI is 1.0 mm or wider. (E-mail: magnus.cinthio@elmat.lth.se).
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| 27. |
- Cinthio, Magnus, et al.
(författare)
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A NEW NON-INVASIVE ULTRASONIC METHOD FOR MEASUREMENTS OF LONGITUDINAL LENGTH ALTERATION OF THE ARTERIAL WALL - FIRST IN VIVO TRIAL
- 2008
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Ingår i: Acoustical Imaging. - 0270-5117. ; 29, s. 39-43
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Konferensbidrag (refereegranskat)abstract
- We have recently shown that there is a previous unknown longitudinal movement present in the arterial wall. We aim now to investigate whether the longitudinal movement causes length alteration of the arterial wall. The objective of this paper was to describe a new non-invasive ultrasonic technique that measures the length alteration of arteries in human in-vivo. Results indicate that a significant length alteration is present in the common carotid artery.
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| 28. |
- Cinthio, Magnus, et al.
(författare)
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An automatic method for measurements of arterial intima-media thickness using ultrasonic B-mode data
- 2012
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Ingår i: Acoustical Imaging. - Dordrecht : Springer Netherlands. - 9789400726185 - 9789400726192 ; 31, s. 115-122
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- We have previously developed algorithms that use B-mode cineloops for simultaneous measurements of arterial diameter change and longitudinal movement of the arterial wall. In this study the lumen diameter algorithm was extended to also measure arterial intima-media thickness of the far wall. To optimize the algorithm the influence of the lateral width of the region-of-interest (1 pixel, 0.1 mm, 0.5 mm, 1 mm, 2.5 mm and 5 mm) was evaluated. The algorithm estimated intima-media thickness at diastole automatically by measuring the distance between the two positions where the laterally averaged B-mode intensity envelope crosses a threshold value relative to the maximum amplitudes of the intimal and adventitial echoes, respectively. The sub-pixel resolution is achieved by solving the equation of a straight line between the two samples on either side of the threshold value. The measurements were performed on 20 healthy normotensive volunteers (age 25–57 years) on the common carotid artery 2–3 cm proximal to the bifurcation. For the 2.5-mm width, which was considered the best, the intima-media thickness was mean 646 μm (SD 66) for men and 613 μm (SD 68) for women. The systematic difference was −5 μm and the random difference was 31 μm. The CV was 4.9%. The study indicates that the reproducibility is sufficient for in vivo studies when the width of the region-of-interest is 1.0 mm or wider.
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| 29. |
- Cinthio, Magnus, et al.
(författare)
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Evaluation of an algorithm for arterial lumen diameter measurements by means of ultrasound.
- 2010
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Ingår i: Medical & Biological Engineering & Computing. - : Springer Science and Business Media LLC. - 0140-0118 .- 1741-0444. ; 48, s. 1133-1140
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Tidskriftsartikel (refereegranskat)abstract
- We have developed an algorithm for arterial luminal diameter measurement by means of ultrasound and evaluated the algorithm on agar vessel phantoms and in vivo. The algorithm utilises relative threshold detection on the inner slopes of the arterial walls before the resolution is improved by solving the equation of a straight line between the samples around the threshold value. Further, correction distances added to compensate for the underestimation when using the inner slopes were found to be 304 mum for the near wall and 415 mum for the far wall. The measured mean diameters of ten consecutive images of 3-, 6- and 9-mm phantoms were 3,006 mum (SD 4), 5,918 mum (SD 1) and 8,936 mum (SD 2), respectively. The mean differences between the images were 0.19, 0.04 and 0.37 mum, respectively. In vivo, the intra- and inter-observer variabilities were -64 mum (2SD 358) and -57 mum (2SD 366), respectively.
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| 30. |
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| 31. |
- Cinthio, Magnus, et al.
(författare)
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Longitudinal movements and resulting shear strain of the arterial wall
- 2006
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Ingår i: American Journal of Physiology: Heart and Circulatory Physiology. - : American Physiological Society. - 1522-1539 .- 0363-6135. ; 291:1, s. 394-402
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Tidskriftsartikel (refereegranskat)abstract
- There has been little interest in the longitudinal movement of the arterial wall. It has been assumed that this movement is negligible compared with the diameter change. Using a new high-resolution noninvasive ultrasonic method, we measured longitudinal movements and diameter change of the common carotid artery of 10 healthy humans. During the cardiac cycle, a distinct bidirectional longitudinal movement of the intima-media complex could be observed in all the subjects. An antegrade longitudinal movement, i.e., in the direction of blood flow, in early systole [ 0.39 mm ( SD 0.26)] was followed by a retrograde longitudinal movement, i.e., in the direction opposite blood flow [ -0.52 mm ( SD 0.27)], later in systole and a second antegrade longitudinal movement [ 0.41 mm ( SD 0.33)] in diastole. The corresponding diameter change was 0.65 mm ( SD 0.19). The adventitial region showed the same basic pattern of longitudinal movement; however, the magnitude of the movements was smaller than that of the intimamedia complex, thereby introducing shear strain and, thus, shear stress within the wall [ maximum shear strain between the intima-media complex and the adventitial region was 0.36 rad ( SD 0.26). These phenomena have not previously been described. Measurements were also performed on the abdominal aorta ( n = 3) and brachial ( n = 3) and popliteal ( n = 3) arteries. Our new information seems to be of fundamental importance for further study and evaluation of vascular biology and hemodynamics and, thus, for study of atherosclerosis and vascular diseases.
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| 32. |
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| 33. |
- Cinthio, Magnus, et al.
(författare)
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New Approaches in Arterial Characterisation
- 2008
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Ingår i: Proceedings of 11th International Symposium on Advanced Biomedical Ultrasound (Invited). ; , s. 3-8
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- —The aim of this paper is to briefly present the historyand the status of the arterial characterization of today as wellas summarize our work on two new approaches in arterialcharacterization – measurements of the longitudinal movementand the minute roughness of the arterial wall.
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| 34. |
- Cinthio, Magnus, et al.
(författare)
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New improved and modified method for measurements of arterial wall movements in longitudinal and radial directions
- 2005
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Ingår i: Medical physics : proceedings of the jointly held congresses ICMP 2005, 14th International Conference of the Medical Physics of the International Organization for Medical Physics (IOMP), the European Federation of Organisations in Medical Physics (EFOMP) and the German Society of Medical Physics (DGMP) [and] BMT 2005, 39th annual congress of the German Society for Biomedical Engineering (DGBMT) ; 14th - 17th September 2005, Nuremberg, Germany. ; 50, s. 869-870
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 35. |
- Cinthio, Magnus, et al.
(författare)
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New improved method for 2D arterial wall movement measurements
- 2005
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Ingår i: Proceedings of the International Federation for Medical & Biomedical Engineering. 13th Nordic Baltic Conference on Biomedical Engineering and Medical Physics. - 9173059102 ; , s. 117-118
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Konferensbidrag (refereegranskat)abstract
- We have recently reported that the inner layers of the arteries, the intima-media complex, of common carotid artery, move as much in the longitudinal direction as in the radial direction, during the cardiac cycle. In order to study this phenomenon we have developed a high-resolution ultrasonic method that can simultaneously record both the longitudinal and the radial movements of the arterial wall non-invasively in vivo. However, in young individuals with large movements and with thin intima-media complex it happens sometimes that the echoes from the adventitia region interfere. To be able to minimise the size of the region-of-interest in the radial direction, we suggest that the radial movement of the arterial vessel is first measured and that the radial movement is used as a priori information when the longitudinal movement is measured. The mean difference between the two methods is 8 and 2 standard deviation is 24 μm
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| 36. |
- Cinthio, Magnus, et al.
(författare)
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New non-invasive method for intima-media thickness and intima-media compression measurements
- 2005
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Ingår i: Proceedings - IEEE Ultrasonics Symposium. - 1051-0117. - 0780393821 ; 1, s. 389-392
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Konferensbidrag (refereegranskat)abstract
- Intim a-media thickness (IMT) is considered as a valuable marker of early atherosclerosis. We suggest a new algorithm for simultaneous measurements of absolute diameter at diastole, distension (diameter change), IMT at diastole and the intima-media compression (IMC) with a new fast, robust, high-resolution, and automatic algorithm utilizing the ultrasonic gray-scale information. The new algorithm is evaluated in a limited in vivo study on the common carotid artery of 5 healthy volunteers. The standard deviation within an investigation was (8 ± 4 μm; range 4-14 μm) during IMC measurements, (8 ± 5 μm; range 4-16 μm) during the measurements of the IMT at diastole, (30 ±36 μm; range 6-92 μm) during the distension measurements and (48 ±49 μm; range 15-134 μm) during the measurements of the lumen diameter at diastole. The evaluation shows that the algorithm is fast and that the reproducibility and resolution are more than sufficient for in vivo studies. © 2005 IEEE.
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| 37. |
- Cinthio, Magnus, et al.
(författare)
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Non-invasive measurements of longitudinal strain of the arterial wall
- 2007
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Ingår i: Ultrasonics Symposium, 2007. IEEE, vols 1-6. - 1051-0117. - 9781424413843 ; , s. 570-572
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Konferensbidrag (refereegranskat)abstract
- We have recently shown that there is a previous unknown longitudinal movement present in the arterial wall. The aim is now to investigate whether the longitudinal movement is associated with longitudinal strain of the arterial wall. The objective of this paper was to describe a new non-invasive ultrasonic technique that measures the longitudinal strain of arteries in human in-vivo. Results indicate that a longitudinal strain is present in the common carotid artery.
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| 38. |
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| 39. |
- Duffy, Stephen W., et al.
(författare)
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Mammography screening reduces rates of advanced and fatal breast cancers : Results in 549,091 women
- 2020
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Ingår i: Cancer. - : John Wiley & Sons. - 0008-543X .- 1097-0142. ; 126:13, s. 2971-2979
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is of paramount importance to evaluate the impact of participation in organized mammography service screening independently from changes in breast cancer treatment. This can be done by measuring the incidence of fatal breast cancer, which is based on the date of diagnosis and not on the date of death.Methods: Among 549,091 women, covering approximately 30% of the Swedish screening‐eligible population, the authors calculated the incidence rates of 2473 breast cancers that were fatal within 10 years after diagnosis and the incidence rates of 9737 advanced breast cancers. Data regarding each breast cancer diagnosis and the cause and date of death of each breast cancer case were gathered from national Swedish registries. Tumor characteristics were collected from regional cancer centers. Aggregated data concerning invitation and participation were provided by Sectra Medical Systems AB. Incidence rates were analyzed using Poisson regression.Results: Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years (relative risk, 0.59; 95% CI, 0.51‐0.68 [P < .001]) and a 25% reduction in the rate of advanced breast cancers (relative risk, 0.75; 95% CI, 0.66‐0.84 [P < .001]).Conclusions: Substantial reductions in the incidence rate of breast cancers that were fatal within 10 years after diagnosis and in the advanced breast cancer rate were found in this contemporaneous comparison of women participating versus those not participating in screening. These benefits appeared to be independent of recent changes in treatment regimens.
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| 40. |
- Dussex, Nicolas, et al.
(författare)
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Moose genomes reveal past glacial demography and the origin of modern lineages
- 2020
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Ingår i: BMC Genomics. - : Springer Science and Business Media LLC. - 1471-2164. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Numerous megafauna species from northern latitudes went extinct during the Pleistocene/Holocene transition as a result of climate-induced habitat changes. However, several ungulate species managed to successfully track their habitats during this period to eventually flourish and recolonise the holarctic regions. So far, the genomic impacts of these climate fluctuations on ungulates from high latitudes have been little explored. Here, we assemble a de-novo genome for the European moose (Alces alces) and analyse it together with re-sequenced nuclear genomes and ancient and modern mitogenomes from across the moose range in Eurasia and North America.Results: We found that moose demographic history was greatly influenced by glacial cycles, with demographic responses to the Pleistocene/Holocene transition similar to other temperate ungulates. Our results further support that modern moose lineages trace their origin back to populations that inhabited distinct glacial refugia during the Last Glacial Maximum (LGM). Finally, we found that present day moose in Europe and North America show low to moderate inbreeding levels resulting from post-glacial bottlenecks and founder effects, but no evidence for recent inbreeding resulting from human-induced population declines.Conclusions: Taken together, our results highlight the dynamic recent evolutionary history of the moose and provide an important resource for further genomic studies.
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| 41. |
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| 42. |
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| 43. |
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| 44. |
- Erlöv, Tobias, et al.
(författare)
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A fast 2D tissue motion estimator based on the phase of the intensity enables visualization of the propagation of the longitudinal movement in the carotid artery wall
- 2013
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Ingår i: 2013 IEEE International Ultrasonics Symposium (IUS). - 9781467356855 ; , s. 1761-1764
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Konferensbidrag (refereegranskat)abstract
- A fast 2D motion estimator has been developed and evaluated. The method does not utilize block-matching or iterative solutions and is thus more computationally efficient and suitable for real-time motion estimation over the entire image. The method has been evaluated on 1) phantom measurements and 2) in vivo on the carotid artery wall of 17 subjects, where measurements of the longitudinal displacement of the intima-media complex were compared to our previously validated method. The mean error of the phantom measurements was 2.0 +/- 3.3% (velocities between 2-15 mm/s; approx. 60 million estimations). In the in vivo measurements the mean difference (validated-proposed) was 18 +/- 44 mu m. Further the method has enabled visualization of the propagation of the longitudinal movement in the carotid artery wall. Several different phases of the longitudinal propagation, which seem to be connected to the multi-phasic pattern of the longitudinal movement, can be seen. All phases of the longitudinal propagation seem to originate from the direction of the heart.
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| 45. |
- Erlöv, Tobias, et al.
(författare)
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A method for measuring the variation of intima-media thickness during the entire cardiac cycle using B-Mode images
- 2011
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Ingår i: 2011 IEEE International Ultrasonics Symposium (IUS). - 9781457712531 ; , s. 2126-2129
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Konferensbidrag (refereegranskat)abstract
- Increased intima-media thickness (IMT) has been shown to predict cardiovascular risk, and measurement of intima-media thickness has been extensively used in medical research since the mid-1990s. IMT is conventionally measured by manual tracing, however this method is very time-consuming and suffers from large inter-observer variability. Numerous methods, both semi-automatic and fully-automatic, have been suggested to limit the influence of the observer. However, most methods only report one value per cardiac cycle instead of the variation of IMT over time. We propose a new method that measures the variation of IMT during the entire cardiac cycle. The method tracks spatial variations with compensation for both longitudinal movement and angle variations. This enables detection of positions where an inaccurate measurement of IMT has occurred. These can then be removed from the calculations in order to maximize the accuracy. The method was evaluated in vivo on 20 healthy individuals (mean age 38 years, range 25-57). The overall IMT in diastole (IMTdia) was 717+/-69 mu m and the intima-media compression (IMC) was 66+/-21 mu m which corresponds to a 9.2+/-2.6% maximal compression of the arterial wall during a cardiac cycle. The CV was 3.5% for IMTdia and 9.9% for IMC. Extending traditional IMT measurement to include also the variation of IMT during a cardiac cycle may improve the individual risk classification for cardiovascular diseases.
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| 46. |
- Erlöv, Tobias, et al.
(författare)
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A Method to Measure Shear Strain with High Spatial Resolution in the Arterial Wall Non-Invasively in vivo by Tracking Zero-Crossings of B-Mode Intensity Gradients
- 2010
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Ingår i: Proceedings - IEEE Ultrasonics Symposium. - 9781457703812 ; , s. 491-494
-
Konferensbidrag (refereegranskat)abstract
- We have previously shown that there is a distinct longitudinal movement of the arterial wall during a cardiac cycle. This movement is larger in the intima-media region than in the adventitial region which introduces a substantial shear strain within the arterial wall. Our previously developed echo-tracking algorithm measured this shear strain by tracking two separate echoes, one in the intima-media region and one in the adventitia region and thus only a linear distribution was evaluated. The objective of this study was to suggest and evaluate a new improved method which can measure the intramural shear strain with higher spatial resolution and thereby provide more information on this new and rather unknown phenomenon. The mean maximum shear strain was 0.82 radians with a standard deviation of 0.17 radians and a CV-value of 14.2%. The total mean difference in measured longitudinal movement between the new and previous method was 10μm with a standard deviation of 90μm and a CV-value of 12.8%. The spatial distribution of the intramural shear strain seems to be very non-linear with a large amount of shear strain occurring in a small section around the transition between the media and adventitia layers.
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| 47. |
- Erlöv, Tobias, et al.
(författare)
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A robust and fast method for arterial lumen diameter and intima-media thickness measurements
- 2012
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Ingår i: 2012 IEEE International Ultrasonics Symposium (IUS). - 9781467345613 - 9781467345620 ; , s. 1678-1681
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Konferensbidrag (refereegranskat)abstract
- Lumen diameter, distension and intima-media thickness (IMT) in human arteries are important parameters in cardiovascular research. The signal reflected from the arterial wall strongly depends on the ultrasound scanner and settings. The signal also varies with age and health of the subject. A general method insensitive with respect to the subject and the scanner would be of great help. We have developed a novel and robust method for ARTerIal Characterization (ARTIC), suitable for real-time in vivo measurements of diameter, distension and IMT using B-Mode images. The aim of this study was to evaluate ARTIC on different subjects and scanners. ARTIC was evaluated in vivo in different groups of subjects using two scanners, HDI5000 (Philips Medical Systems, Bothell, WA, USA) and ULA-OP (University of Florence, Italy). First, a comparison was made against a previous method validated on phantoms. Then measurements of young (healthy) and old (healthy and unhealthy) subjects were evaluated for both scanners. Finally, a comparison between scanners was made. The evaluation of different subjects shows a coefficient of variation (CV) ranging from 1.4-2.0% for diameter, 4.3-8.8% for distension and 3.6-6.6% for IMT.
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| 48. |
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| 49. |
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| 50. |
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